Research
Stroke death rates on the rise after 40 years of decline

After 40 years of decline, stroke death rates appear to be on the rise again according to new analysis from the US.
A Rutgers analysis of U.S. stroke deaths from 1975 to 2019 has found both a dramatic decline and the potential for an important resurgence.
Stroke mortality (per 100,0000) plummeted from 88 to 31 for women and 112 to 39 for men between 1975 and 2019 in the United States.
Total stroke deaths fell despite the rise in age-adjusted risk because stroke rates skyrocket as people get older.
A 10 percent reduction in the fatality rate for 75-year-olds would more than offset a doubling of the fatality rate among 35-year-olds because strokes are 100 times more common in 75-year-olds.
However, barring further improvements in stroke prevention or treatment, the most recent figures demonstrate that total stroke fatalities will rise as millennials age. Age-adjusted stroke deaths per 100,000 people bottomed out in 2014 and climbed again during the last five years of the study period.
“Starting around 1960, the later you were born, the higher your risk of suffering a fatal ischemic stroke at any particular age,” said Cande Ananth, chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School, and lead author of the study.
“This study didn’t identify a cause for this trend, but other research suggests the main culprits are increasing rates of obesity and diabetes.”
The analysis used a comprehensive death-certificate database to identify virtually every adult under the age of 85 who died from a stroke during the 44 years – 4,332,220 deaths in all.
It was the first stroke-death analysis to divide patients by their year of birth (cohort) and the first to identify the steady rise in age-adjusted ischemic stroke risk from the late 1950s to the early 1990s.
This “age-period-cohort analysis,” which further divided patients by their age at death, also allowed the study team to make two other novel insights:
- Stroke fatality rates have fallen more for ischemic strokes, which occur when blood vessels to the brain are blocked, than hemorrhagic strokes, which occur when blood vessels leak or burst. The ischemic stroke fatality rate fell roughly 80 percent over the study period, while the hemorrhagic stroke fatality rate fell roughly 65 percent.
- The disparity between male and female stroke fatality rates diminishes as patient age increase. At age 55, men are more than twice as likely as women to suffer a fatal stroke, but the disparity in the rates of fatal stroke is virtually identical at age 85.
Ananth said: “After nearly four decades of declining stroke-related mortality, the risk appears to be increasing in the United States. Our research underscores the need for novel strategies to combat this alarming trend.”
News
Older male athletes may face increased risk of serious heart problems during exercise

Veteran male athletes may face higher heart risk during exercise if they have existing heart scarring, new research suggests.
The study found that male endurance athletes aged over 50 were more likely to experience abnormal heart rhythms during training if scarring was present.
Nine in 10 sudden cardiac deaths during sport occur in older male athletes.
Researchers at the University of Leeds tracked 106 healthy male endurance athletes aged over 50 who had been doing more than 10 hours of running or cycling weekly for at least 15 years.
They matched training data from wearables with implantable loop recorders to align heart rhythms with activity.
Over two years, about one in four participants experienced ventricular tachycardia, a fast, abnormal rhythm arising from the heart’s lower chambers, during or just after exercising.
Three quarters of those who had these episodes had heart scarring. There were three sustained episodes during exercise, all in athletes with scarring.
Scarring may be caused by heart attacks, disease or cumulative exertion from years of high-intensity exercise.
Dr Wasim Javed, research fellow at the University of Leeds and lead author, said: “Our study shows that exercise was only associated with a risk of developing abnormal heart rhythms in those who were already high risk due to heart scarring.
“Athletes who developed abnormal heart rhythms were not exercising more or harder than athletes without abnormal heart rhythms.
“This suggests that exercise itself is not the cause, but could act as a trigger for dangerous heart rhythms in those athletes already with an underlying heart issue.”
“Exercise is safe and has immense benefits – but athletes in this group should have regular health checks to make sure they stay healthy.”
The researchers said their findings support the use of wearable technology for athletes who want to monitor their heart rate for unusual activity.
Research
Childhood exposure to indoor air pollution linked to long term brain harms

Childhood exposure to indoor air pollution may have long-term effects on brain health, with cognitive impairment appearing decades later, new research suggests.
The study analysed data from over 7,000 Chinese adults aged 45 and above using machine learning techniques.
Nearly 30 per cent of the global population, roughly 2.4bn people, still cook without clean fuels such as gas or electricity, instead using solid fuels like coal, wood and plant waste.
Researchers at the University of Helsinki found that individuals exposed as children to indoor air pollution from solid fuels performed significantly worse on cognitive tests in adulthood, particularly in episodic memory and overall mental health.
The study identified two main pathways through which childhood exposure may contribute to poorer cognitive performance: biological, including being overweight and limitations in daily activities; and socioeconomic, with exposure associated with lower education and income levels.
Men, smokers and regular alcohol users were particularly vulnerable to the detrimental effects.
Xu Zong, the study’s author, said: “Our study emphasises that early exposure to air pollution affects later cognitive health through both biological and social pathways.
“That is why public health efforts should combine clean energy initiatives with preventive strategies that support lifelong health and positive behaviours.
“Switching to cleaner fuels, such as gas or electricity, is not merely an environmental or respiratory health measure.
“It is also an investment in long-term cognitive wellbeing that could safeguard brain health for future generations.”
News
Finding could help identify diabetes patients at risk of vascular damage

The longer someone has type 2 diabetes, the higher their cardiovascular disease risk, and changes in red blood cells may help explain it, new research suggests.
The study found red blood cells from patients with long-term diabetes harmed blood vessel function, while no such effect was seen in those newly diagnosed.
After seven years of follow-up, the blood cells of people initially diagnosed had developed the same harmful properties.
Zhichao Zhou, associate professor at Karolinska Institutet and lead author, said: “What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease.
“It is only after several years that red blood cells develop a harmful effect on blood vessels.”
Researchers at Karolinska Institutet in Sweden studied animals and patients with type 2 diabetes.
They identified microRNA-210, a small RNA that helps regulate gene activity, as a possible early biomarker of cardiovascular risk.
When its levels were restored in red blood cells, blood vessel function improved.
Eftychia Kontidou, doctoral student and first author, said: “If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications.”
The researchers are now investigating whether the biomarker can be used in larger population studies.
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