Burden of stroke in Estonia

Estonia is the smallest of the three Baltic countries. The decline in incidence of first-ever stroke during the 1990s has left Tartu, Estonia with a relatively low stroke incidence. However, the incidence rates for younger age groups, and the 28-day case fatality rate are higher compared with several other studies. Developments in the national health care system in recent years have been positive: the decline of mortality rate of stroke in Estonia is greater than the European Union average. However, the mortality of cardiovascular diseases is higher compared with several European countries. The prevalence of most stroke risk factors is comparable with European Union countries, while atrial fibrillation is somewhat more frequent (30%) among the patients having suffered from ischemic stroke. The management of stroke in Estonia has been in accordance with European and national stroke guidelines. Stroke units are organized in regional and central hospitals in bigger cities. A well-developed and free ambulance service, and a high priority of stroke code, enable a quick transportation of patients to the nearest hospital providing thrombolytic therapy. The number of thrombolyzed stroke cases has increased since 2003. The Estonian Stroke Initiative was founded in 2008 to improve stroke care, promote regional networks, and increase stroke knowledge among the general population and medical professionals. Since then, several activities regarding stroke awareness have been organized.