Thirty-year projections for deaths from ischemic stroke in the United States.

BACKGROUND AND PURPOSE The age adjustment of stroke mortality rates may obscure the impact of population changes on the total burden of disease. Deaths from ischemic stroke may rise unless future declines in stroke death rates offset the projected growth in high-risk populations. METHODS Using data on ischemic stroke mortality from the National Center of Health Statistics for 1979 to 1998, we fit a logistic model to predict changes in stroke death rates as a function of time for each of 42 sex-race-age groups. Using population projections from the US Census Bureau, we then calculated the expected number of deaths in the United States from ischemic stroke over the next 30 years on the basis of age, sex, and race. RESULTS Models generally fit historical data well (median R2=0.81; interquartile range, 0.43 to 0.97) and consistently predicted small declines in future death rates. The total predicted number of stroke deaths increased by 98% from 139,000 in 2002 to 275,000 in 2032, whereas the total US population was projected to increase by only 27% in the same period. The largest percentage increases in stroke deaths were predicted to occur in blacks (134%) and nonwhite, nonblack races (221%). CONCLUSIONS If recent trends in ischemic stroke mortality continue, increases in US stroke deaths will outpace overall population growth, with a doubling in deaths over the next 30 years.