An epidemiological study was conducted of geographic differences in stroke mortality between the following areas within the United States: Savannah, Georgia (high stroke rates), Hagerstown, Maryland (intermediate stroke rates) and Pueblo, Colorado (low stroke rates). Population samples 35-54 years of age of the three cities were drawn for interview and examination to determine medical conditions and living habits of these populations. The population samples were compared with emphasis on

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... e risk factors for stroke: serum cholesterol and glucose tolerance test determinations, weight and height measurements, blood pressure and cigarette smoking. The gradient of increasing prevalence of strokerelated risk factors from low to intermediate to high for the three cities was present for blood pressure in black females and white males and for glucose tolerance tests in whites and nonwhites. No other consistent pattern of increasing prevalence of risk factors for stroke was evident. THREE AREAS, Savannah, Georgia with a high mortality from stroke, Pueblo, Colorado with a low and Hagerstown, Maryland, with an intermediate mortality from stroke were selected to explore possible reasons for mortality differences. 1 In each area a population sample was selected for interview and medical examination in an attempt to elucidate explanatory factors. In all, 2,375 subjects were interviewed, of whom 1,939 were examined. Laboratory determinations, blood pressure measurements, and ECG readings were obtained on at least 97% of those examined. This is a report of the results of the study.