Hypertension
and Diabetes Cause Dramatic Increase in Stroke
Hospitalizations
Hypertension,
with diabetes, has contributed to a 39.5% increase
in stroke hospitalizations in South Carolina from
1991 to 2000.
South Carolina is an important region for the
epidemiological study of stroke because it has
the highest rate of cardiovascular disease in
the United States, according to Dr. Daniel T.
Lackland of the Medical University of South Carolina,
Charleston. With regards to stroke risk, "a
45-year-old male in the Southeast is like a 65-year-old
in Minnesota," he said.
The researchers found that secondary diagnoses
of hypertension and diabetes in patients discharged
after stroke increased 79% and 38%, respectively,
over the 10-year period. Dr. Lackland presented
his study at the meeting of the American Society
of Hypertension last Saturday.
One reason for this observation is the prevalence
of uncontrolled hypertension in the South. "In
clinical trials we can control blood pressure
in 90% of the people. In our population, it's
less than one in four," Dr. Lackland noted.
The researchers conducted the study by analyzing
all hospitalizations in South Carolina from 1991
to 2000, including discharges from military and
veteran's administration institutions. All primary
diagnoses of stroke were included.
The data were analyzed separately for patients
up to 50 years old and for those over 50, and
for the year 2000, the most recent year for which
data were available. The researchers found that
stroke hospitalization rates increased 32.8% for
patients under 50, compared with 40.1% for those
50 and older. In 2000, secondary diagnoses of
hypertension were associated with 50.2% of stroke
discharges and secondary diagnoses of diabetes
with 29.7%.
The number of hospitalizations for stroke is a
more sensitive indicator of the changing incidence
of stroke over time than mortality, Dr. Lackland
said, because the technology for keeping stroke
patients alive keeps improving. "Blood pressure
control is much more cost-effective, if you want
to look at it that way, than paying for hospitalization,"
he added.
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