Abstract Details

Title Trends in the prevalence of stroke among community-dwelling individuals in the U.S.: 1999-2018

Topic General Neurology

Presentation(s) S19 - Neuroepidemiology (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Background There is a lack of recent data on trends in stroke prevalence among community dwelling individuals in the U.S. Prior epidemiological reports indicate decreasing stroke incidence and decreasing stroke mortality. Accurate and up-to-date representative estimates of stroke prevalence are needed to inform public health interventions.

Objective To estimate the prevalence of stroke among community-dwelling individuals in the U.S. between 1999 and 2018 using a nationally representative sample.

Design/Methods We performed a series of cross-sectional analyses of data from 2,197 participants aged 20+ years in the 1999-2018 National Health and Nutrition Examination Surveys (NHANES) with self-reported history of stroke. We calculated age-standardized stroke prevalence over four-year epochs overall, and stratified by age group, sex, and race/ethnicity. Using the American Community Survey Public Use Microdata Sample from 2017-2018, we estimated the number of persons affected by stroke.

Results

The overall age-standardized prevalence of stroke was 3.1% (95%CI: 2.9%-3.3%) from 1999-2002 to 2015-2018, which corresponds to 7.4 million (7.0-7.9 million) affected individuals. The age-standardized prevalence of stroke was stable from 1999-2002 to 2015-2018 (p-value-for-linear-trend-across-four-year-epochs=0.332). The age-standardized prevalence of stroke from 1999-2002 to 2015-2018 was higher among older individuals (aged ≥60 years: 7.7%, 7.2%-8.2%) compared to younger individuals (aged 20-39 years: 0.4%, 0.3%-0.5%; aged 40-59 years: 2.0%, 1.8%-2.3%), among non-Hispanic Black individuals (4.7%, 4.3%-5.1%) compared to other race/ethnicities (non-Hispanic White: 2.9%, 2.7%-3.2%; Mexican American: 2.6%, 2.3%-3.0%; Other: 3.5%, 2.8%-4.2%; Asian American: 1.7%, 1.3%-2.3%), and was similar by sex (men: 2.9%, 2.7%-3.2%; women: 3.2%, 3.0%-3.5%). The prevalence of stroke in each age, sex, and race/ethnicity group was stable from 1999-2002 to 2015-2018

Conclusions The age-standardized prevalence of stroke in the non-institutionalized civilian adult population of the U.S. has not significantly changed between 1999 and 2018. In the context of other reports this likely reflects a combination of decreasing stroke incidence and improved stroke outcomes.

Authors/Disclosures
Wells Andres, MD PRESENTER	Dr. Andres has nothing to disclose.
Aaron Rothstein, MD	Dr. Rothstein has nothing to disclose.
Holly Elser, MD, PhD (Hospital of the University of Pennsylvania)	Dr. Elser has nothing to disclose.
Kelly Sloane, MD	The institution of Dr. Sloane has received research support from National Center for Advancing Translational Sciences of the National Institutes of Health: KL2TR001879.
Scott E. Kasner, MD, FAAN (University of Pennsylvania)	Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol-Myers Squibb. Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Diamedica. Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Dr. Kasner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Javelin. Dr. Kasner has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for UpToDate. The institution of Dr. Kasner has received research support from Bristol-Myers Squibb. The institution of Dr. Kasner has received research support from Medtronic. The institution of Dr. Kasner has received research support from WL Gore.
Rebecca F. Gottesman, MD (Johns Hopkins University)	Dr. Gottesman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Gottesman has received research support from NIH.
Andrea L. Schneider, MD, PhD (University of Pennsylvania)	Dr. Schneider has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN - Neurology.