Stroke Mortality Rates in Poland Did Not Decline Between 1984 and 1992

Ryglewicz, Danuta; Polakowska, Maria; Lechowicz, Waldemar; Broda, Grażyna; Rószkiewicz, Małgorzata; Jasiński, B; Hier, Daniel B.

doi:10.1161/01.str.28.4.752

Cited by 28 publications

(12 citation statements)

References 18 publications

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“…Case-fatality rates in older men and in younger women also declined in Dijon as was the case in other populations 8,9,13,16 but not in all cases. 5,20,21 The determinants of better case-fatality rates were LI, lower systolic and diastolic blood pressure, younger age and the last time period.…”

Section: Discussionmentioning

confidence: 99%

Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Bénatru

Rouaud

Durier

et al. 2006

Stroke

166

139

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Background and Purpose-With the progress in stroke prevention, it is important to evaluate the epidemiological trends of strokes over a long period and from a nonselected population-based perspective. Methods-We estimated changes in incidence, case-fatality rates, severity, risk factors and prestroke use of preventive treatments for first-ever strokes, from a continuous 20-year well-defined population-based registry, from 1985 to 2004. Results-We recorded 3142 ischemic strokes, 341 primary cerebral hemorrhages and 74 subarachnoid hemorrhages.During the 20-year study, the age at first stroke onset increased by 5 years in men and 8 years in women. Comparing the 1985 to 1989 and the 2000 to 2004 periods, age-and sex-standardized incidences of first-ever strokes were stable except for lacunar strokes whose incidence significantly increased (Pϭ0.01) and for cardioembolic stroke whose incidence significantly decreased (Pϭ0.01). Twenty-eight-day case-fatality rates decreased significantly mainly for lacunar strokes (Pϭ0.05) and for primary cerebral hemorrhages (Pϭ0.03). The proportion of hypercholesterolemia and diabetes significantly increased (PϽ0.01). In contrast, the proportion of myocardial infarction significantly decreased (Pϭ0.02). Prestroke antiplatelets and anticoagulants treatment significantly increased (PϽ0.01). Conclusions-The age-and sex-standardized incidences of first strokes in Dijon have been stable over the past 20 years and were associated with an increase in age at stroke onset, a decrease in case-fatality rates, and an increased use of antiplatelet treatments.

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Section: Discussionmentioning

confidence: 99%

Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Bénatru

Rouaud

Durier

et al. 2006

Stroke

166

139

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“…No decline in mortality was observed in Warsaw, Poland. 23 In Shanghai, China, virtually no decline in stroke incidence occurred, but a clear decline in stroke mortality was reported. 24 In general, stroke mortality increased in eastern Europe in the second half of the 1980s and the early 1990s.…”

Section: Discussionmentioning

confidence: 99%

Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland

Sivenius

Tuomilehto

Immonen-Räihä

et al. 2004

Stroke

104

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Background and Purpose-The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997. Methods-The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women. Results-The rates of acute stroke events fell during the whole study period in both men and women. In both FINSTROKE areas combined, the average annual decline in the age-standardized incidence of first stroke events was 2.0% (95% confidence interval [CI], Ϫ2.8 to Ϫ1.2; PϽ0.001) among men and 1.7% (95% CI, Ϫ2.6 to Ϫ0.8; PϽ0.001) among women. The decline in the incidence of ischemic stroke was even steeper, 2.9%/y (95% CI, Ϫ4.9 to Ϫ1.1; PϽ0.001) among men and 3.1%/y (95% CI, Ϫ5.0 to Ϫ1.1; PϽ0.001) among women, whereas the incidence of intracerebral hemorrhage and subarachnoid hemorrhage did not change. Mortality from all stroke events declined in the FINSTROKE areas by 3.7%/y (95% CI, Ϫ5.3 to Ϫ2.0; PϽ0.001) among men and by 4.1%/y (95% CI, Ϫ5.9 to Ϫ2.4; PϽ0.001) among women. The 28-day case fatality of all stroke events also tended to decline, but the decline was of borderline statistical significance only (Pϭ0.07 among men, Pϭ0.05 among women). Conclusions-Incidence

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“…A decline in incidence in the 1970s and 1980s was reported in the United States [27, 28], Asia [29]and Europe [30, 31], but this decline appears to have levelled off and incidence is now increasing in some areas [32, 33, 34, 35, 36, 37, 38]. Data from the World Health Organization MONItoring of trends and determinants of CArdiovascular disease (WHO MONICA) Stroke Project have shown a general tendency towards declining stroke incidence rates in people aged 35 to 64 years [39].…”

Section: Primary Prevention: Are Current Strategies Reducing Stroke Imentioning

confidence: 99%

Incidence, Risk Factors and Prognosis of Stroke and TIA: The Need for High-Quality, Large-Scale Epidemiological Studies and Meta-Analyses

Rothwell¹

2003

Cerebrovasc Dis

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Stroke is a considerable clinical, social and economic burden. In recent clinical trials, a number of strategies have been shown to reduce the risk of stroke and transient ischaemic attack (TIA) in both primary and secondary prevention settings. Whether these treatments are leading to a significant reduction in the incidence of first and recurrent stroke in the clinic, however, remains unclear due to a paucity of high-quality epidemiological data. A similar lack of reliable epidemiological studies has undermined our understanding of the relationship between many potentially important vascular risk factors and stroke risk. Improvement in our knowledge of stroke epidemiology is a prerequisite for the planning of stroke services, the effective application of current stroke prevention strategies, the development of new strategies, and our understanding of the mechanisms of stroke. Future studies must take into account the clinical and pathological heterogeneity of TIA and stroke, and must be powered to allow subtype differences in risk factor relationships and prognosis to be determined reliably. In many cases, this will require meta-analysis of detailed individual patient data from multiple independent studies.

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Stroke Mortality Rates in Poland Did Not Decline Between 1984 and 1992

Abstract: Two different population-based studies suggest that stroke mortality is high in Poland because of high 28-day case-fatality rates. Stroke mortality failed to decline in Poland in the period 1984 through 1992 because neither case fatality nor stroke incidence declined in this period.

Cited by 28 publications

References 18 publications

Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland

Incidence, Risk Factors and Prognosis of Stroke and TIA: The Need for High-Quality, Large-Scale Epidemiological Studies and Meta-Analyses

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