A marked increase of ischemic stroke incidence between 1980 and 1994 in S. Caterina, Sicily

Stroke death rates have been declining for some decades in most of the industrialized countries. It is not clear, whether this has been associated with a decrease in stroke incidence. We studied temporal trends in stroke incidence in a rural community in Sicily, during two periods 1980-84 and 1990-94. There was a total of 231 patients (120 of them women). The diagnosis of stroke was based on the clinical evaluation and CT scan since 1982 and onward. There were 109 ischemic strokes (51 women) mean age 72.7 years, in 1980-84 period; 122 ischemic strokes (69 women) mean age 75.1, in 1990-94 period. Cardiovascular risk factor rates did not change in the two periods considered. The relative annual stroke incidence rate increased 37.0%; (2.7 in 1980-84 to 3.7/1000 inhabitants in 1990-94, p = 0.0161. In the population older than 65 years, the same parameter increased by 21.1% between the two periods; (16.1 in 1980-84 to 19.5/1000 inhabitants in 1990-94, not significant). This increase was due mainly to a 45.3% significant relative increase in women, from 7.5 to 11.0/1000 inhabitants (p = 0.039). These findings suggest a need of the reconsideration of effective strategies for the prevention of stroke.