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Stroke trends in the WHO MONICA project
P Thorvaldsen1, K Kuulasmaa, A M Rajakangas
1Glostrup Population Studies, Glostrup University Hospital, Denmark. thorvald@inet.uni-c.dk
Stroke
|March 1, 1997
Summary
Stroke attack and mortality rates declined in most populations studied by the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease (WHO MONICA) Project. However, statistically significant trends were observed in only a few populations.
Area of Science:
- Cardiovascular epidemiology
- Public health surveillance
- Neurology
Background:
- Established stroke registers within the WHO MONICA Project across 17 international centers.
- Utilized a standardized protocol for stroke event ascertainment and validation.
Purpose of the Study:
- To estimate and compare temporal trends in stroke incidence and mortality.
- To analyze stroke trends across diverse MONICA populations.
Main Methods:
- Analyzed nearly 25,000 stroke events over 15 million person-years.
- Calculated age-standardized rates for fatal and all stroke events.
- Estimated temporal trends using 5-6 years of annual rate data.
Main Results:
- Stroke attack rates decreased in 13/17 male populations and 15/17 female populations.
- Stroke mortality rates declined in 11/17 male populations and 14/17 female populations.
- Statistically significant trends were infrequent, despite observed declines.
Conclusions:
- A general decrease in stroke rates is suggested across many populations.
- The limited number of statistically significant trends prevents definitive conclusions on the reality of changes in specific populations.