1. Epidemiology of Stroke Dexter L. Morris, PhD, MD Department of Emergency Medicine University of North Carolina School of Medicine Chapel Hill, NC

2. Dexter L. Morris, PhD, MD Stroke Incidence and Prevalence 600,000 new strokes each year 160,000 deaths US: 83% of strokes ischemic, 17% hemorrhagic

3. Dexter L. Morris, PhD, MD 19 Age-adjusted stroke mortality rate/100,000 Age-Adjusted Stroke Mortality Rates in the United States from 1979 to 1998 by Race and Gender

4. Dexter L. Morris, PhD, MD Death rates of each HSA compared to U.S. rate (1988-92) Stroke- White Male

5. Dexter L. Morris, PhD, MD 19 Total Deaths from Stroke in the United States by Year,1979-1998 Stroke deaths in thousands, United States Total age-adjusted stroke mortality rate/100,000 Year

6. Dexter L. Morris, PhD, MD Total Stroke Deaths in the United States by Race and Age, 1998 Stroke deaths in thousands Age group Total Deaths

7. Dexter L. Morris, PhD, MD Risk Factors For Stroke Hypertension Previous Stroke/TIA Heart Disease Atrial Fibrillation Carotid Bruit Diabetes Smoking Older > Younger Black > Hispanic Hispanic > White Male > Female

8. Dexter L. Morris, PhD, MD Natural History of Stroke Death –7.5% of ischemic and 37.5% hemorrhagic stroke patients die within 30 days Disability –Of those who survive 30 days, 20% require institutional care

9. Dexter L. Morris, PhD, MD Stroke Healthcare Costs Stroke is a leading cause of long term disability in the US Approximately 1 million hospital admissions per year for stroke Total costs for stroke in US over 45 BILLION dollars a year

10. Dexter L. Morris, PhD, MD Summary Stroke is a huge disease in the United States It causes a tremendous amount of mortality and disability Although stroke rates may be declining, the number of strokes will become greater because of increases in population and the aging of the population

11. Dexter L. Morris, PhD, MD Summary (cont) Hypertension is the major controllable/treatable risk factor for stroke Emergency Medicine Physicians have an increasingly important role in the treatment and prevention of this disease