Cerebrovascular disease mortality among Baltimore residents aged 20-64.

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Abstract
A sample of all nontraumatic deaths among Baltimore residents age 20-64 was studied to determine the frequency of cerebrovascular disease [CVD]. After reviewing hospital records medical examiners'' reports, autopsy protocols, and information from physicians and families of the deceased, cerebrovascular disease was reported in 602 of the deaths for ages 40-64. In only 256 (42.5%) was CVD listed as the underlying cause on the death certificate. The types of CVD were determined by reviewing similar types of records. Although there appeared to be a fairly good correlation between clinical diagnoses and causes of death as reported on the death certificates in deaths due to subarachnoid hemorrhage and cerebral hemorrhage, the relationship between the clinical and pathological diagnoses of cerebral thrombosis and the underlying cause on the death certificates for those deaths was very poor. Over 25.% of all deaths in Negro females had a reported history of CVD. The death rates were higher in Negro females whether the total CVD deaths, those in which it was the principal diagnosis, or those in which it was the underlying cause of death on the death certificate were considered. Rates were also higher in Negroes for both cerebral thrombosis and hemorrhage. One-third of the deaths due to cerebral thrombosis had a history of diabetes mellitus. Some of the values and limitations of using mortality information to describe the epidemiology of CVD are discussed, with the need to review death certificates in which cerebrovascular disease was not the underlying cause, in order to obtain a better picture of CVD mortality.