Mortality from Cerebrovascular Disease

Abstract

Average annual cerebrovascular disease (CVD) mortality rates (age-adjusted to the 1950 US population) were calculated using data from 1967 through 1973 for 33 countries. Rates range from 35.8/100,000/year (Philippines) to 196.7/100,000/year (Japan). There is also considerable variation among the nations of Europe and North America. Comparing these results with similar information for the 1950s shows a marked decrease for CVD mortality in approximately two-thirds of the countries for which data are available. Nations with low rates in the 1950s generally show an increase in CVD mortality rates. This most probably represents improvements in case ascertainment and diagnosis. Despite the problems inherent in mortality tabulations for neurologic diseases, the data reveal interesting patterns.

Trends in mortality from cerebrovascular disease in Taiwan.

“…21 This phenomenon probably can be explained, to some degree, by the fact that people in the urban district are sufficiently well educat- ed to realize and avoid the risks of cerebrovascular disease, and have better medical care with resultant decrease in the fatality rate. For instance, it has been shown that there was a decline of cholesterol and triglyceride levels in residents of Taipei city from 1973 to 1977, but not in residents of San-Chih county, a rural area near Taipei city.…”

“…In a study of mortality rates from ischemic heart disease (THD) from 1968 through 1976 for 27 countries, 21 Epstein and Pisa concluded that there is a tendency towards a decline for countries whose initial IHD mortality rates were high and the reverse is true for those with initially low rates. Ko reported that the IHD mortality rate in Taiwan was on the increase from 1971 to 1980.…”

“…6 As described earlier, during this period cerebrovascular disease mortality was on the decrease. The hypothesis that the decrease in cerebrovascular disease mortality is attributable to an increase in coronary heart disease, 21 is unsupported by some reports and still needs further investigation. •American mortality data were age-adjusted to the 1970 U.S. census population by the direct method for each sex-color group.…”

The Cost of Stroke to the National Health Service in Scotland

“…Although mortality from cerebrovascular disease has decreased during this century in many developed coun tries [1,2], stroke is still the third largest cause of death in Great Britain and the U nited States and places a heavy burden on the individual, the community and health ser vices. Figures from the Oxford Community Stroke Pro ject suggest that about 111,000 people in Great Britain had a first-ever stroke in 1988 (crude annual incidence rate 2/1,000) [3], and prevalence estimates suggest that between 3-4 times that many people in the comm unity suffer from the after-effects of a stroke [4][5][6].…”