Declining stroke burden among white and black male veteran subjects

The prevalence of hypertension and diabetes is increasing. We hypothesized that this could contribute to increasing burden of stroke—the third leading cause of mortality—and investigated national trends in stroke burden among blacks and whites. From October 1990 to October 1997, 55,094 veterans were admitted with diagnosis of ischemic stroke (International Classification of Diseases [ICD] code 434 or 436) at any veterans hospital in the country were included in the study. We extracted demographic data from Veterans’ Administration administrative databases. Discharge ICD-9 codes were used to assess stroke risk factors. Patients were classified as white or black, and prevalence of stroke was calculated and stratified according to age. Overall annual incidence rate fell from 2.7 per 1,000 in 1991 to 1.67 per 1,000 in 1997. Annual incidence number of stroke declined steadily in both the white and black groups from 1991 to 1997. Incidence numbers fell for all ages with greater decrease in younger age groups. Our data indicate that the burden of stroke among male veterans is decreasing. This appears to be true for both blacks and whites and across all age groups.