Acute stroke in a metropolitan area, 1970 and 1980. The Minnesota Heart Survey.

Mortality rates for stroke, and hospitalization and case fatality rates for acute stroke in 1970 and 1980 were obtained for residents aged 30-74 of the Twin Cities (Minneapolis--St Paul) metropolitan area to determine whether improved hospital care contributed to the decline in stroke mortality. Age-adjusted mortality rates per 100,000 declined significantly in that decade for men (1970, 89.4; 1980, 47.5; p less than 0.01) and women (1970, 72.6; 1980, 40.9; p less than 0.01). Age-adjusted hospitalization rates per 100,000 population also declined significantly for men (1970, 438; 1980, 323; p less than 0.01) and women (1970, 331; 1980, 203; p less than 0.01). Age-adjusted mean length of hospital stay did not change significantly. Hospital case fatality declined for men aged 30-64 years (1970, 22.5%; 1980, 15.1%; p less than 0.01) but did not change significantly for 65 to 74 year-old men (1970, 16.5%; 1980, 20.0%; p = 0.09) or for all women (age-adjusted rates: 1970, 13.6%; 1980, 16.0%; p = 0.17). There was no change in the distribution of severity of hospitalized cases between years. Therefore, the decline in stroke mortality is consistent with a decreased incidence of stroke resulting from improved hypertension control. Improvements in hospital medical care appear not to have contributed substantially to the decline in stroke mortality.