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Increasing stroke incidence and decreasing case fatality, 1989-1998: a study from the stroke register in Malmö,

Hélène Pessah-Rasmussen1, Gunnar Engström, Ingela Jerntorp

  • 1Department of Neurology, Malmö University Hospital, Sweden. Helene.pessah-rasmussen@skane.se

Stroke
|March 22, 2003
PubMed
Abstract

Insights

Stroke incidence increased in Malmö from 1989-1998, particularly in younger individuals and less socioeconomically deprived areas. Case fatality rates improved for women but not men.

Area of Science:

  • Epidemiology
  • Cardiovascular Research
  • Public Health

Background:

  • Myocardial infarction (MI) incidence and mortality have declined in industrialized nations.
  • Stroke incidence trends are less consistent globally.
  • Socioeconomic factors may influence stroke incidence and outcomes.

Purpose of the Study:

  • To examine time trends in stroke incidence.
  • To analyze stroke case fatality rates.
  • To investigate the relationship between stroke trends, socioeconomic status, and history of MI.

Main Methods:

  • Continuous monitoring of stroke incidence in Malmö, Sweden (250,000 citizens) from 1989 to 1998.
  • Inclusion of all first-ever stroke patients aged 50–79 years.
  • Analysis of age-standardized incidence, case fatality rates, and proportion with prior MI.

Main Results:

  • Age-standardized stroke incidence was 647/100,000 for men and 400/100,000 for women.
  • Annual incidence increased by 3.1% in men and 2.9% in women, more in younger age groups.
  • Incidence increase was lowest in socioeconomically deprived areas; prior MI history was stable; case fatality declined significantly in women (OR 0.895/year) but not men.

Conclusions:

  • Stroke incidence rose in this urban population between 1989 and 1998.
  • The rate of increase in stroke incidence was lower in areas with less favorable socioeconomic circumstances.
  • While stroke case fatality improved significantly for women, no significant improvement was observed for men during the study period.

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