The impact of cerebrovascular disease.

Stroke may be affected by pathologic conditions such as atherosclerosis, vascular injury, coagulopathy, and increased platelet aggregability. Knowledge of the pathophysiology of stroke is critical in order to effectively prevent or treat this disabling state. Cerebrovascular disease is the third leading cause of death in the USA. It is also associated with significant morbidity, leading to extremely high health care costs and lost productivity. Total estimated costs of stroke are estimated to be more than $45 billion annually. This is an especially important issue for patients with diabetes, who are at higher risk for stroke and have a worse clinical outcome than non-diabetic patients. This review describes the impact of vascular disease, particularly cerebrovascular disease, and describes the pathophysiology of the disease. Interventions that result in reduction of stroke will likely result in decreased health care costs and improved clinical outcomes.