Monitoring Health Care in America

Quarterly Fact Sheet – September 1996

Spotlight on: Stroke

Cerebrovascular disease is the third leading cause of death in America, accounting for over 154,000 deaths in 1994. This fact is true despite death rates from stroke having actually dropped nearly every year since 1950. In 1993, 109 years of potential life were lost due to stroke for every 100,000 persons under age 65. Stroke is the third leading cause of death for all people age 45 and over. Death rates from cerebrovascular disease are greater for women than for men and for black persons than for white persons.

In 1993 the national death rate from stroke was 26.5 deaths per 100,000 population. During the period 1990-92, age-adjusted death rates by State ranged from 20.8 for Rhode Island to 40.0 for South Carolina. Regionally, cerebrovascular disease mortality is highest for Indiana and what is referred to as the “stroke belt,” the southeastern states of Louisiana, Mississippi, Alabama, Georgia, North Carolina, South Carolina, Virginia, Tennessee, Kentucky, and Arkansas. The lowest rates are in Colorado, New Mexico, Arizona, Nebraska, Iowa, and Florida, as well as the northeastern states of Maine, Vermont, New York, Massachusetts, Connecticut, and Rhode Island.

According to 1994 data, nearly 3 million Americans have suffered strokes at some point, or 1 per 100 population. Five percent of males aged 65 and over and 6 percent of women in the same age group have suffered a stroke. The South has the greatest prevalence of cerebrovascular disease, while the Northeast has the lowest.

Use of health services

In 1993 there were nearly 841,000 hospital discharges for inpatients with a first-listed diagnosis of cerebrovascular disease, compared with 648,000 discharges in 1978. An estimated 349,000 of stroke-related hospitalizations in 1993 were due to occlusion of the cerebral arteries, while 266,000 were due to occlusion and stenosis of the precerebral arteries. Stroke patients spent an average of 8.4 days in the hospital in 1993, compared with 13.4 days in 1978. In 1993, patients between the ages of 15 and 44 spent an average of 9 days in the hospital for cerebrovascular disease.

Over 4.4 million inpatient surgical procedures were performed on the cardiovascular system in 1993. More than half of these procedures were performed on patients ages 65 and over, and nearly 3.8 million were performed on patients ages 45 and up. The most common procedure was cardiac catheterization (over 1 million performed annually), followed by coronary artery bypass grafts (485,000), and removal of coronary artery obstruction, including angioplasty (398,000).

Over 3.4 million visits to hospital emergency departments in 1994 were due to diseases of the circulatory system. Nearly 11 million electrocardiograms (EKG) were performed on these patients. Almost 4.2 million visits were made to hospital outpatient departments in 1994 for diseases of the circulatory system, and nearly 1.4 million EKGs were provided… In addition, more than 54 million office visits in 1994 were made to physicians for diseases of the circulatory system.

For further information about “Monitoring Health Care in America” contact the NCHS office of Public Affairs at 301-458-4800 or via e-mail at

Data Sources

Health, United States

Health, United States, 1995. 328 pp. (PHS) 96-1232. GPO stock number 017-022-01339-8 price $25.00 [PDF – 2 MB]

Monthly Vital Statistics Report

Annual Summary of Births, Marriages, Divorces, and Deaths: United States, 1994. Vol. 43 No. 13. 42 pp. (PHS) 95-1120 [PDF – 523 KB]

Vol. 43, No. 7, Supplement. Advance Report of Final Mortality Statistics, 1993.

Vital and Health Statistics Series Report

No. 122. Detailed Diagnoses and Procedures, National Hospital Discharge Survey, 1993. 288 pp. (PHS) 95-1783. GPO stock number 017-022-01323-1 price $24.00 [PDF – 1.6 MB]

No. 121. National Hospital Discharge Survey: Annual Summary, 1993. 63 pp. (PHS) 95-1782. GPO stock number 017-022-01317-7 price $5.00 [PDF – 489 KB]

Advance Data from Vital and Health Statistics

No. 273. National Ambulatory Medical Care Survey: 1994 Summary. 20 pp. (PHS) 96-1250 [PDF – 300 KB]

No. 264. 1993 Summary: National Hospital Discharge Survey. 12 pp. (PHS) 95-1250 [PDF – 108 KB]