One of the main reasons fewer Americans are dying from stroke now than they were 60 years ago is fairly simple, a new paper published by the American Heart Association explains.

From the report

"The association of blood pressure levels and risk of stroke was first recognized by the Society of Actuaries in the 1920s. In 1960, early clinical studies identified clear benefits of lowering blood pressure on reducing stroke deaths. In the Veterans Administration clinical trials for those with severe hypertension, the effect was dramatic. After just 18 months, those who received placebo were having strokes at such an increased rate that the trial was stopped and all the participants were given antihypertensive drugs."

"Factors Influencing the Decline in Stroke Mortality," published Dec. 5 by the American Heart Association.

Our blood pressure is lower than it used to be.

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"In the 1970s a group of epidemiologists got together and said if we could shift blood pressure ... of adults by 10 mmHg, we can reduce stroke rates by this percentage," said Daniel Lackland, an epidemiologist at the Medical University of South Carolina.

"How accurate is that information? We've shown it's very, very accurate. It was right on the money."

Lackland headed a national team of scientists that collectively wrote the new American Heart Association report titled, "Factors Influencing the Decline in Stroke Mortality." It was published Thursday.

Between 1960-62, average systolic blood pressure was 131 mmHg. Between 2001-08, the average fell to 122 mmHg. The American Heart Association considers normal systolic blood pressure 120 mmHg or lower.

The paper shows that stroke mortality rates have fallen too. In 1950, the age-adjusted stroke mortality rate in the U.S. was 88 deaths per 100,000 people. By 2010 that rate dropped to 23 deaths per 100,000, the report said.

But stroke mortality rates in this state and in surrounding southern states remain higher than the national average.

South Carolina is located in the heart of the country's "stroke belt," which runs an arc from Virginia to Louisiana. The stroke mortality rate in South Carolina in 2010 was 47.9 deaths per 100,000 residents, according to the federal Centers for Disease Control and Prevention, making it the sixth-highest stroke mortality rate in the country.

The South Carolina Heart and Stroke Care Alliance estimates that strokes kill 35 residents in the state every day.

MUSC announced last week that it won a $1.7 million grant from the federal National Institutes for Health to serve as a regional stroke coordinating center for the NIH stroke network.

The network is designed to promote clinical trials to study stroke prevention and recovery.

"Instead of doing one trial, seeing if it works, and then doing another trial, there will be multiple trials going on concurrently. You'll have four or five trials going on in the network at any given time," said Dr. Edward Jauch, director of the division of emergency medicine at MUSC.

It will give stroke patients in South Carolina better access to promising treatments, Jauch said.

Southern states have traditionally been underrepresented in these clinical trials, he said.

Palmetto Health in Columbia and the Greenville Hospital System also will participate in the stroke network project.

Reach Lauren Sausser at 937-5598.