[Improved survival after stroke but unchanged risk of incidence]

Stroke is the third most common cause of death in Sweden. With almost one million hospital days pro year, stroke consumes more hospital days than any other somatic disease. Each year between 27,000 and 35,000 have a stroke and the mean age of stroke patients in Sweden is now 75 years (73 years for men and 77 for women). Swedish studies have shown that the stroke incidence has been unchanged or even increasing slightly over the lasts decades. However, the stroke mortality has decreased, mainly because the case fatality has improved. In patients younger than 75 years, the Northern Sweden MONICA study has shown that the case fatality has declined from almost 20% 1985 to 11% in 1998. One important reason for the declining case fatality is probably the improved care of the stroke patients. In 1994 half of the patients were treated in a stroke unit. Today 73% of all patients are treated in a stroke unit. With an ageing population and an improved survival, the prevalence of stroke will increase as long as the incidence is unchanged. This means that the number of stroke patients will increase health care facilities at all levels. Therefore, it is very important to reduce or eliminate risk factors for stroke. Preventing a stroke saves much suffering for both patients and relatives and reduces the economic burden for the society.