ArticleStroke2019
Stagnating National Declines in Stroke Mortality Mask Widespread County-Level Increases, 2010-2016.
Article in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incidence and risk factors for stroke after hip fracture: a meta-analysis.Scientific reports · 2023Pooled it
- National trends in stroke hospitalisations, mortality, and recurrent stroke in Australia and New Zealand.Scientific reports · 2025Article
- Pervasive stagnation: flat and increasing cardiovascular disease mortality rates after 2010 across US states and counties.American journal of epidemiology · 2025Article
- Ischemic Stroke Mortality in Type 2 Diabetes in the U.S.: National Trends and Demographic Disparities From 1999 to 2019.Endocrinology, diabetes & metabolism · 2025Article
- Applying a Bayesian spatiotemporal model to examine excess county-level cardiovascular disease death rates during the COVID-19 pandemic.American journal of epidemiology · 2025Article
- Case fatality rate and associated factors of mortality among first-ever stroke patients: a prospective cohort study in Erbil City, Iraq.The Pan African medical journal · 2025Article
- Improving Blood Pressure Control and Tobacco Use Cessation Intervention In Primary Care: Protocol for the Alabama Cardiovascular Cooperative Heart Health Improvement Project.JMIR research protocols · 2024Article
- A dispensable role of mural cell-derived laminin-Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Sex Differences in Trends in Stroke Recurrence and Postrecurrence Mortality 2000-2020: Population-Based Brain Attack Surveillance in Corpus Christi Project.Annals of neurology · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- US County-Level Variation in Preterm Birth Rates, 2007-2019.JAMA network open · 2023Article
- State and Local Health Departments: Research, Surveillance, and Evidence-Based Public Health Practices.Preventing chronic disease · 2023Article
- Twenty-Year Disparity Trends in United States Stroke Death Rate by Age, Race/Ethnicity, Geography, and Socioeconomic Status.Neurology · 2023Article
- Sleep duration trajectories and all-cause mortality among Chinese elderly: A community-based cohort study.BMC public health · 2023Article
- Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.Circulation · 2023Review
- Differences in Geographic Patterns of Absolute and Relative Black-White Disparities in Stroke Mortality in the United States.Preventing chronic disease · 2022Article
- Demographic and Regional Trends in Stroke-Related Mortality in Young Adults in the United States, 1999 to 2019.Journal of the American Heart Association · 2022Article
- A Dynamic Visualization Tool of Local Trends in Heart Disease and Stroke Mortality in the United States.Preventing chronic disease · 2022Article
- County-Level Trends in Hypertension-Related Cardiovascular Disease Mortality-United States, 2000 to 2019.Journal of the American Heart Association · 2022Article
- Rural-urban differences in stroke risk.Preventive medicine · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Background and Purpose- Recent national and state-level trends show a stalling or reversal of previously declining stroke death rates. These national trends may mask local geographic variation and changes in stroke mortality. We assessed county-level trends in stroke mortality among adults aged 35 to 64 and ≥65 years. Methods- We used data from National Vital Statistics Systems and a Bayesian multivariate space-time conditional autoregressive model to estimate age-standardized annual stroke death rates for 2010 through 2016 among middle-aged adults (35-64 years) and older adults (≥65 years) in US counties. We used log-linear regression models to estimate average annual and total percent change in stroke mortality during the period. Results- Nationally, the annual percent change in stroke mortality from 2010 to 2016 was -0.7% (95% CI, -4.2% to 3.0%) among middle-aged adults and -3.5% (95% CI, -10.7% to 4.3%) among older adults, resulting in 2016 rates of 15.0 per 100 000 and 259.8 per 100 000, respectively. Increasing county-level stroke mortality was more prevalent among middle-aged adults (56.6% of counties) compared with among older adults (26.1% of counties). About half (48.3%) of middle-aged adults, representing 60.2 million individuals, lived in counties in which stroke mortality increased. Conclusions- County-level increases in stroke mortality clarify previously reported national and state-level trends, particularly among middle-aged adults. Roughly 3×as many counties experienced increases in stroke death rates for middle-aged adults compared with older adults. This highlights a need to address stroke prevention and treatment for middle-aged adults while continuing efforts to reduce stroke mortality among the more highly burdened older adults. Efforts to reverse these troubling local trends will likely require joint public health and clinical efforts to develop innovative and integrated approaches for stroke prevention and care, with a focus on community-level characteristics that support stroke-free living for all.
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