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Stroke in Northern Sweden.

Birgitta Stegmayr1, Kjell Asplund

  • 1Medicine, Department of Public Health and Clinical Medicine Umeå University, Umeå, Sweden. birgitta.stegmayr@medicine.umu.se

Scandinavian Journal of Public Health. Supplement
|December 9, 2003
PubMed
Summary

Stroke event rates remain stable, but declining case fatality reduces mortality. Despite this, the increasing elderly population suggests a growing stroke burden in Sweden.

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Area of Science:

  • Epidemiology
  • Public Health
  • Cardiovascular Research

Background:

  • Stroke is a leading global cause of death and disability.
  • While mortality has decreased in many developed nations, some regions, like Eastern Europe, face increasing stroke mortality.
  • The World Health Organization's MONICA Project aimed to track trends in coronary heart disease and stroke, linking them to risk factors.

Purpose of the Study:

  • To analyze stroke event rates and case fatality trends in Northern Sweden from 1985 to 1998.
  • To compare these trends with international data.
  • To understand the factors contributing to changes in stroke mortality.

Main Methods:

  • Utilized the Northern Sweden MONICA stroke register, including individuals aged 25-74 with acute stroke.
  • Validated data from death certificates, hospital discharge records, and general practitioner records using strict MONICA criteria.
  • Employed logistic regression to analyze case fatality trends.

Main Results:

  • Stroke incidence (first ever and recurrent) showed minimal variation between 1985 and 1998, with no significant secular trends observed.
  • The 28-day case fatality rate significantly decreased from 19% to 11% in both men and women.
  • Northern Sweden exhibited an intermediate stroke incidence but one of the lowest case fatality rates among participating populations, with high subarachnoid hemorrhage incidence.

Conclusions:

  • The reduction in stroke mortality in Sweden is solely attributable to decreased case fatality.
  • Stroke event rates have remained constant since 1985.
  • An aging population entering higher-risk age groups indicates a projected increase in the overall burden of stroke in Sweden.

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