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Stroke Kills More Americans Than Europeans
--Different Health Risks and Barriers to
Healthcare Are to Blame

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By Susan M. Callahan, Associate Editor and Featured Columnist



February 22, 2008, Last Updated March 9, 2011




                        

The higher prevalence of stroke in the United States and
the lower stroke prevalence in Mediterranean populations
may be due in part to cross-country differences in risk
factors and to barriers to care in the United States.

“Southern Mediterranean countries have a diet rich in
vegetables, fruits and fish and lower in fats, which partly
explains why heart disease is so much lower in these
populations than in northern Europe and the United
States,” Avendano said.

“However, for stroke, the picture is more complicated.  For
instance, although Italy has relatively low stroke
prevalence, former studies indicate that Italians have a
similar or higher stroke incidence rate than people in other
European countries or the United States.  Thus, the results
on prevalence may also reflect poor stroke survival in Italy,
which will result in a lower prevalence of stroke.”

“Prevalence” is an a estimate of the total number of cases
of a disease existing in a population during a specified
period. While “incidence” is an estimate of the number of
new cases of a disease that develop in a population, usually
in a one-year period.

Higher stroke prevalence was associated with lower
socioeconomic status as measured by wealth, income and
education, but these associations were stronger in the
United States than in most European countries.

“Beyond the contribution of specific risk factors, policies
that differ dramatically between Europe and the United
States may play a role,” Avendano said.  This includes
healthcare access, which is universal in Europe but not in
the United States, and “the preventive orientation of some
European systems aimed at tackling stroke risk factors, as
opposed to the U.S. healthcare system, which focuses more
on treatment and may actually be more successful in
keeping stroke cases alive.”

Furthermore, policies related to nutrition and
transportation for example may make Americans more
prone to less physical activity and less healthy diets than
their counterparts in many European countries, he said.

“Risk factors alone do not account for the differences we
found, which points to the role of broader healthcare and
structural policies,” he said.

The study was partially funded by the U.S. National
Institute of Aging, the Netherlands Organisation for
Scientific Research and several British government
departments.



Statements and conclusions of study authors that are
published in the American Heart Association\American
Stroke Association scientific meetings are solely those of
the study authors and do not necessarily reflect association
policy or position.  The American Heart Association makes
no representation or warranty as to their accuracy or
reliability.










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