HOSPITAL CARE FOR PATIENTS WITH STROKES IN THE ACUTE STAGE

Death statistics for cerebrovascular disease: a review of recent findings

There is a large margin of error in death statistics. Mortality statistics for cerebrovascular disease show, however, the well-known rise in frequency with age, the higher frequency in men than women which is likely to affect all countries in the coming years, and the greater involvement of nonwhite Americans and Japanese than of white Americans and Japanese Americans. I believe that incidence figures, when they become available in future years, will confirm these findings. Environmental factors, such as a "water factor," also relate to cerebrovascular death rates. Possibly the biggest factor in the medical environment, causing artificial swings in both mortality and incidence figures, will be shown to be the changing diagnostic habits of physicians.

From the viewpoint of etiology, the coexistence of hypertension and cerebrovascular disease dominates the epidemiological picture. The geographic distribution of cerebrovascular mortality in the U.S.A., and the higher mortality in Negroes and in the elderly, particularly relate to underlying hypertension. Ongoing and future population studies, focusing on morbidity as well as mortality, are likely to contribute much in clarifying the relative importance of other causal factors whose harmful effects can be controlled.