[Cerebrovascular disease in the Taiwan area: past, present and future]

Before the end of the World War II, both hypertension and stroke were found to be less frequent among Taiwanese and little attention was paid to cerebrovascular disease (CVD). Since the late 1950s, the rising population of the aged in Taiwan, resulting from improved medical facilities and health care, have largely accounted for the increased number of CVD deaths. From 1957 to 1977, the tempo of increase in CVD deaths paralleled that in the elderly population. From 1963 to 1981, CVD was the leading cause of death. Community-based stroke registry surveys revealed the higher annual incidence, death rate and prevalence rate of stroke in our population than in Japan or western communities. Since 1981, active participation of neurologists and the availability of computed tomography (CT) in Taiwan, have created a new era in the management of stroke patients. Data from three teaching hospitals in Taipei and from 26 hospitals in Taiwan showed about 35% of acute strokes were diagnosed as cerebral hemorrhage (CH) by CT. Deaths from CH comprised 60% to 70% of the total stroke deaths, and hypertensive was the most important risk factor for both CH and cerebral infarct (CI). With improvement of medical facilities and increasing awareness of CVD, the mortality rate for CH dropped from 53.7% in 1978 to 33.3% in 1981, and further to about 25% in 1985. The effective anti-hypertension campaign started in 1986 has contributed to further reduction of the incidence and fatality of stroke.(ABSTRACT TRUNCATED AT 250 WORDS)