Temporal Trends in Sex Differences With Regard to Stroke Incidence

Giroud, M.; Delpont, Benoît; Daubail, Benoît; Blanc, Christelle; Durier, Jérôme; Giroud, Maurice; Béjot, Yannick

doi:10.1161/strokeaha.116.015913

Cited by 68 publications

(61 citation statements)

References 17 publications

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“…We previously showed an increase in stroke incidence over the same period [11]. The present study highlights the fact that the total number of strokes rose over time, concomitantly with a decrease in fatal cases, thus leading to an increase in patients who survived after the event.…”

Section: Discussionsupporting

confidence: 68%

“…It complies with the defined criteria for conducting “ideal” incidence stroke studies [9], and the guidelines for the reporting of incident and prevalent strokes in neuroepidemiology according to the Standards of Reporting of Neurological Disorders [10]. Case-collection as well as adjudication procedures have been described extensively elsewhere [2, 3, 11]. Multiple overlapping sources of information are used to identify stroke patients in this geographically defined area, whatever their management (as inpatients or outpatients).…”

Section: Methodsmentioning

confidence: 99%

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Increasing Burden of Stroke: The Dijon Stroke Registry (1987–2012)

et al. 2018

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Background: We aimed to provide a representation of the global burden of stroke. Methods: All cases of stroke were prospectively identified through the population-based registry of Dijon, France (1987–2012). Attack rates and mortality rates (defined as stroke leading to death within 30 days) were standardized to the European standard. Sex differences and temporal trends were evaluated by calculating rate ratios (RRs). Results: In all, 5,285 stroke cases (52.7% women) were recorded. The standardized attack rate was 98.2/100,000/year and the mortality rate was 12/100,000/year, and both were lower in women than in men (RR 0.67, p < 0.001, and RR 0.70, p < 0.001, respectively). Attack rates increased over time (RR 1.016; 95% CI 1.013–1.020) irrespective of the stroke subtype. In contrast, mortality rates declined (RR 0.985; 95% CI 0.976–0.995) with decreasing rates for ischemic stroke but no change for intracerebral hemorrhage and subarachnoid hemorrhage. The sex gap in both attack and mortality rates remained stable. Between the first (1987–1991) and the last (2007–2012) study periods, the annual number of stroke patients who survived beyond 30 days rose by 55%, Conclusions: Increasing attack rates and decreasing mortality have led to a rise in the number of stroke survivors in the population, thus indicating a growing need for the implementation of dedicated services.

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Section: Discussionsupporting

confidence: 68%

Section: Methodsmentioning

confidence: 99%

Increasing Burden of Stroke: The Dijon Stroke Registry (1987–2012)

et al. 2018

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“…The Dijon Stroke Registry is an ongoing population-based study, whose aim is to identify all cases of stroke and TIA that occur within the population of the city of Dijon, Eastern France (152,000 inhabitants) [7, 8]. It complies with the defined criteria for conducting “ideal” incidence stroke studies [1, 9], and the guidelines for the reporting of incident and prevalent strokes in neuroepidemiology according to the Standards of Reporting of Neurological Disorders [10].…”

Section: Methodsmentioning

confidence: 99%

“…It complies with the defined criteria for conducting “ideal” incidence stroke studies [1, 9], and the guidelines for the reporting of incident and prevalent strokes in neuroepidemiology according to the Standards of Reporting of Neurological Disorders [10]. Details about the methodology of case-collection have been provided elsewhere [7, 8]. Prospectively collected data are obtained from multiple overlapping sources of information using the following “hot” and “cold” pursuit procedures: (1) Daily checks of medical records of all patients referred to Dijon University Hospital where the only stroke unit of the area is located; (2) Review of medical records from the departments of private hospitals of the city and its suburbs; (3) Review of medical records of patients hospitalized at Dijon University Hospital, for whom a dedicated computerized hospital diagnostic codes is compatible with a stay for stroke or TIA.…”

Section: Methodsmentioning

confidence: 99%

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Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Béjot¹,

Brenière²,

Graber³

et al. 2017

Neuroepidemiology

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Background: We aimed to evaluate the epidemiological features of transient ischemic attack (TIA). Methods: All TIAs were prospectively collected in Dijon, France, using a population-based registry (2013–2015). TIAs were considered the first-ever in patients who had no previous cerebrovascular events (CVEs); otherwise they were considered recurrent TIAs. Annual incidence (first-ever TIAs) and attack rates (first-ever and recurrent TIAs) were calculated. Results: Four hundred twenty TIAs were registered (255 first-ever and 165 recurrent TIAs, mean age: 74.1 ± 15.7 years). The age-standardized incidence rate (to the 2013 European population) was 61 (95% CI 46–76) and the attack rate was 81 (95% CI 64–99) per 100,000/year. Patients with TIA as a recurrent event had a greater prevalence of risk factors and preventive treatments. However, one third of them were not receiving antithrombotic agents or antihypertensive treatments, and half were not treated with statins at the time of their recurrence. The mean ABCD² score was 4.3 ± 1.3, and 72% of patients had a high risk of recurrence (score ≥4). In patients with available MRI (23%), an infarct lesion was seen in 15.5%. Conclusions: TIA is a frequent occurrence and a large proportion of patients have a high risk of recurrence, thus highlighting the need to establish dedicated emergency services to administer prompt secondary prevention.

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Assessment of Incidence and Risk Factors of Intracerebral Hemorrhage Among Participants in the Framingham Heart Study Between 1948 and 2016

et al. 2020

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ICH) has the highest mortality of all stroke types and is the most serious complication of anticoagulation. Data regarding trends in ICH incidence and location-specific risk factors on the population level are conflicting.OBJECTIVE To assess long-term population-based trends in the incidence of ICH, examine incidence rates stratified by deep and lobar locations, and characterize location-specific risk factors. DESIGN, SETTING, AND PARTICIPANTSThis longitudinal prospective community-based cohort study comprised 10 333 original participants (n = 5209; age range, 28-62 years) and offspring participants (n = 5124; age range, 5-70 years) from the Framingham Heart Study who were followed up from January 1, 1948, to December 31, 2016. Original and offspring patient cohorts were confirmed to have experienced a spontaneous ICH event through imaging or pathologic testing. A total of 129 participants were identified with a primary incident of ICH. After exclusions, the remaining 99 patients were divided into 2 nested case-control samples, which were created by stratifying the first incident of ICH by brain region (lobar ICH or deep ICH), with 55 patients included in the lobar ICH sample and 44 patients included in the deep ICH sample. Patients were matched by age and sex (1:4 ratio) with 396 individuals without any stroke event (the control group). No participant in the patient samples was excluded or approached for consent, as their initial consent to participate in the Framingham Heart Study included consent to follow-up of cardiovascular outcomes. Data were analyzed in October 2019. MAIN OUTCOMES AND MEASURESThe unadjusted and age-adjusted ICH incidence rates, assessed in 3 periods (period 1, from 1948-1986; period 2, from 1987-1999; and period 3, from 2000-2016) to study incidence trends. Nested case-control samples were used to examine baseline risk factors and medication exposures with the incidence of ICH events located in the lobar and deep brain regions within the 10 years before participants experienced a stroke event.RESULTS Of 10 333 original and offspring participants in the Framingham Heart Study, 129 patients (72 women [55.8%]; mean [SD] age, 77 [11] years) experienced a primary ICH incident during a follow-up period of 68 years (301 282 person-years), with an incidence rate of 43 cases per 100 000 person-years. The unadjusted incidence rate increased over time, but the age-adjusted incidence rate decreased slightly between periods 2 and 3. An age-stratified analysis indicated a continued increase in ICH incidence among patients 75 years and older, reaching 176 cases per 100 000 person-years in period 3. A concurrent 3-fold increase in the use of anticoagulant medications was observed, from 4.4% in period 2 to 13.9% in period 3. The incidence rate increased substantially with age for both lobar and deep ICH. Higher systolic and diastolic blood pressure and statin medication use (odds ratio [OR], 4.07; 95% CI, 1.16-14.21; P = .03) were associated with the incidence of deep ICH. Higher systolic blood pressur...

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Temporal Trends in Sex Differences With Regard to Stroke Incidence

Abstract: The sex gap in stroke incidence did not change with time except for subarachnoid hemorrhage. Despite lower rates, more women than men experience an incident stroke each year because of a longer life expectancy.

Cited by 68 publications

References 17 publications

Increasing Burden of Stroke: The Dijon Stroke Registry (1987–2012)

Increasing Burden of Stroke: The Dijon Stroke Registry (1987–2012)

Contemporary Epidemiology of Transient Ischemic Attack in Dijon, France (2013–2015)

Assessment of Incidence and Risk Factors of Intracerebral Hemorrhage Among Participants in the Framingham Heart Study Between 1948 and 2016

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