Stroke and vascular mortality trends in France: 1979-2001

The therapeutic armamentarium for vascular risk factors in industrialized countries improved over the past decades. We therefore studied vascular mortality trends in France between 1979 and 2001, and explored how these trends are related to stroke or nonstroke vascular mortality changes.

We included all deaths from vascular disease in the French population from 1979 to 2001. Trends for total, stroke and nonstroke vascular mortality were estimated using log-linear Poisson regression models. Gender-specific mortality rates were standardized directly by 5-year groups to the 1990 French population.

During the 1979-2001 period, the mean annual percentage change in vascular death rates varied across age groups (<35, 35-54, 55-64, 65-74, >or=75) between -2.4 to -3.3% in men and -2.5 to -4.1% in women. Respectively, 25.7 and 30.9% of total vascular death was attributed to cerebrovascular disease in men and women. Stroke mortality and nonstroke vascular mortality rates declined respectively by 60.9 and 34.6% in men, and 60.4 and 38.9% in women.

We observed a dramatic 60% reduction of stroke death in France in the last 20 years. Stroke death decreased at about twice the rate as other causes of vascular death. Improved management of vascular risk factors could partly explain these results.