Changed Incidence and Case-Fatality Rates of First-Ever Stroke Between 1970 and 1993 in Tartu, Estonia

Kõrv, Janika; Roose, Mai; Kaasik, Ain‐Elmar

doi:10.1161/01.str.27.2.199

Cited by 33 publications

(28 citation statements)

References 18 publications

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“…High blood pressure is the major underlying cause of cardiovascular morbidity and mortality in industrialised countries as well as in less developed countries. [2][3][4] Major reductions in cardiovascular deaths and disability have been proven to be a direct result of detection and treatment of high blood pressure (HBP) including studies showing that the provision of free care for hypertensives lowers blood pressure better than co-pay systems in the US. 5 The rapidly changing psychosocial milieu and disintegration of the health care system in the former Soviet Union countries has resulted in an increase in uncontrolled CVD risk factors and is likely the explanation for the sudden increase in CVD deaths in Eastern Europe.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cardiovascular risk factors in the Republic of Georgia

Grim²,

Petersen

et al. 1999

J Hum Hypertens

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Background: Eastern Europe is experiencing an epidemic of deaths from cardiovascular diseases with an increase since the early 1990s approaching 50%. The ability to survey the risk factors associated with this striking rise is severely hampered by the current disarray of the area's public health system. We used a rapid survey method to describe the epidemiology of cardiovascular risk in the capital of the Republic of Georgia, Tbilisi. Methods: A two-stage cluster design, 'rapid survey method' developed by the Chronic Disease Center was used to estimate the frequency of hypertension, a major cardiovascular risk factor. Local personnel were trained and certified in blood pressure measurement and rapid survey techniques. The training and survey were conducted over a period of 14 days at which time a prelimi-

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Section: Introductionmentioning

confidence: 99%

Prevalence of cardiovascular risk factors in the Republic of Georgia

Grim²,

Petersen

et al. 1999

J Hum Hypertens

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“…However, a marked decrease was seen in northern Europe (Denmark, 10 Finland, 11 and northern Sweden 9 ) and in Australia, 19 and an increase was seen in Estonia, 20 Lund-Orup, 21 and the Malmö and Örebro areas 22 in southern and central Sweden. No decline in mortality was observed in Warsaw, Poland.…”

Section: Discussionmentioning

confidence: 99%

Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland

Sivenius

Tuomilehto

Immonen-Räihä

et al. 2004

Stroke

104

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Background and Purpose-The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997. Methods-The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women. Results-The rates of acute stroke events fell during the whole study period in both men and women. In both FINSTROKE areas combined, the average annual decline in the age-standardized incidence of first stroke events was 2.0% (95% confidence interval [CI], Ϫ2.8 to Ϫ1.2; PϽ0.001) among men and 1.7% (95% CI, Ϫ2.6 to Ϫ0.8; PϽ0.001) among women. The decline in the incidence of ischemic stroke was even steeper, 2.9%/y (95% CI, Ϫ4.9 to Ϫ1.1; PϽ0.001) among men and 3.1%/y (95% CI, Ϫ5.0 to Ϫ1.1; PϽ0.001) among women, whereas the incidence of intracerebral hemorrhage and subarachnoid hemorrhage did not change. Mortality from all stroke events declined in the FINSTROKE areas by 3.7%/y (95% CI, Ϫ5.3 to Ϫ2.0; PϽ0.001) among men and by 4.1%/y (95% CI, Ϫ5.9 to Ϫ2.4; PϽ0.001) among women. The 28-day case fatality of all stroke events also tended to decline, but the decline was of borderline statistical significance only (Pϭ0.07 among men, Pϭ0.05 among women). Conclusions-Incidence

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“…[17][18][19] In the 1980s, incidence figures tended to increase, coinciding with the introduction of CT, which may have increased the detection of less severe strokes. 19,20 During the 1980s and early 1990s, very small variations in stroke incidence were seen in New Zealand, 21 western Europe, 13,[22][23][24] Russia, 25 and North America 26 ; a marked decrease was seen in northern Europe 27,28 and in Australia 29 ; and an increase was seen in middle-aged populations from northern Sweden, 30 in Estonia, 31 and in Lund-Orup, a neighboring county of Malmös. 32 Thus, our figures corroborate the finding that the incidence of first-ever stroke is increasing in south Sweden, especially in the male middle-aged population.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Increasing Stroke Incidence and Decreasing Case Fatality, 1989–1998

Pessah‐Rasmussen

Engström

Jerntorp

et al. 2003

Stroke

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Background and Purpose-Although the incidence of and mortality from myocardial infarction (MI) have declined in most industrialized countries, incidence studies of stroke have shown less consistent trends. This study examines time trends in the incidence of stroke and case fatality rates in relation to socioeconomic circumstances and history of MI. Methods-Stroke incidence in the city of Malmö, Sweden (250 000 citizens), has been continuously monitored since 1989.All patients 50 to 79 years of age who experienced a first-ever stroke between 1989 and 1998 were included. Results-We included 3621 patients (1969 men, 1652 women). The age-standardized incidence was 647 per 100 000 persons-years for men and 400 per 100 000 persons-years for women. The annual increase-3.1% in men (PϽ0.05) and 2.9% in women (PϽ0.05)-was more pronounced in the younger age groups and was lowest in areas with poor socioeconomic circumstances. We found that 13% of the men and 6% of the women had a history of MI; this proportion was stable over the study period. The average case fatality rates in 1989 to 1998 were 10% for men and 9.3% for women. Rates remained stable for men but declined significantly in women (odds ratio per year, 0.895; 95% confidence interval, 0.84 to 0.95). Conclusions-In this urban population, stroke incidence increased between 1989 and 1998. The rate of increase tended to be lower in residential areas with least favorable socioeconomic circumstances. The proportion with a history of MI remained unchanged during the study period. There has been significant improvement in the case fatality rate in women but not in men.

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Changed Incidence and Case-Fatality Rates of First-Ever Stroke Between 1970 and 1993 in Tartu, Estonia

Cited by 33 publications

References 18 publications

Prevalence of cardiovascular risk factors in the Republic of Georgia

Prevalence of cardiovascular risk factors in the Republic of Georgia

Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland

Increasing Stroke Incidence and Decreasing Case Fatality, 1989–1998

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