TY - JOUR
T1 - The US decline in stroke mortality
T2 - What does ecological analysis tell us?
AU - Jacobs Jr, David R
AU - McGovern, P. G.
AU - Blackburn, Henry
PY - 1992
Y1 - 1992
N2 - We review a study in this issue that concludes, from analyses of ecological associations, that the use of medication to lower high blood pressure has caused at most a small decline in US stroke mortality rates. Our analysis suggests that other possible sources of the decline may be population-wide falls in levels of blood pressure, cigarette smoking, and coronary heart disease mortality, as well as improved treatment of cardiac and respiratory sequelae of stroke. Although the ecological method is powerful for answering questions about medical interventions' population- wide effects on disease, it must be used with care. Of particular concern are variables with meanings that differ between the ecological and the individual levels, the number of ecological units available for analysis, the sample size within the ecological units, and the range of independent variables used in ecological regression.
AB - We review a study in this issue that concludes, from analyses of ecological associations, that the use of medication to lower high blood pressure has caused at most a small decline in US stroke mortality rates. Our analysis suggests that other possible sources of the decline may be population-wide falls in levels of blood pressure, cigarette smoking, and coronary heart disease mortality, as well as improved treatment of cardiac and respiratory sequelae of stroke. Although the ecological method is powerful for answering questions about medical interventions' population- wide effects on disease, it must be used with care. Of particular concern are variables with meanings that differ between the ecological and the individual levels, the number of ecological units available for analysis, the sample size within the ecological units, and the range of independent variables used in ecological regression.
UR - http://www.scopus.com/inward/record.url?scp=0026453777&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026453777&partnerID=8YFLogxK
U2 - 10.2105/AJPH.82.12.1596
DO - 10.2105/AJPH.82.12.1596
M3 - Comment/debate
C2 - 1456332
AN - SCOPUS:0026453777
SN - 0090-0036
VL - 82
SP - 1596
EP - 1599
JO - American journal of public health
JF - American journal of public health
IS - 12
ER -