Seasonal Variation in Incidence of Stroke in a General Population of 1.4 Million Japanese: The Shiga Stroke Registry

Fujii, Takako; Arima, Hisatomi; Takashima, Naoyuki; Kita, Yoshikuni; Miyamatsu, Naomi; Tanaka‐Mizuno, Sachiko; Shitara, Satoshi; Urushitani, Makoto; Miura, Katsuyuki; Nozaki, Kazuhiko

doi:10.1159/000518370

Cited by 9 publications

(9 citation statements)

References 42 publications

(36 reference statements)

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“…Various studies from different regions of the world support a winter peak in the incidence of stroke. [4][5][6][7][8][9][10][11][12] Seasonality in several cardiovascular risk factors may explain this winter peak, specifically in the elderly population. Fibrinogen, for instance, is an independent risk factor for cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

“…3 Seasonal variations in the incidence of stroke have been examined in numerous studies worldwide. Most studies reported a winter peak in the occurrence of stroke, [4][5][6][7][8][9][10][11][12] others found no seasonal variation [13][14][15] and fewer showed a summer peak 16 or an autumn peak. 17 Data on whether seasonality of stroke differs with age are limited.…”

Section: Introductionmentioning

confidence: 99%

“…Those who did, may have lacked the power to reveal a significant seasonal trend in the young age categories, due to smaller numbers, 8 or used broad age categories (⩾70 vs <70), which may not adequately represent young adults. 7 The etiologies of ischemic cerebrovascular events, as well as the prevalence of cardiovascular risk factors, are known to differ with age 18,19 and vary across different seasons. 20,21 This may lead to seasonal variation in the occurrence of events according to age, and thus hold important epidemiological and practical implications to better understand and reduce the burden of stroke.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age-dependent seasonality in the incidence of stroke: A 21-year population-based study

Libruder,

Yaari,

Fluss

et al. 2024

European Stroke Journal

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Introduction: Seasonality in the incidence of stroke has been examined in numerous studies, yet data on whether it differs with age are limited. To fill this gap, we utilized a largescale dataset from Israel. Patients and methods: We retrieved data of all hospitalizations for ischemic stroke (IS), transient ischemic attack (TIA) and intra cerebral hemorrhage (ICH) from 2000 to 2020. We maintained separate datasets for IS/TIA and ICH, divided into five age groups: 18–49, 50–59, 60–69, 70–79, and 80+. We modeled the monthly incidence using a generalized additive model. The seasonal effect was defined by the rate ratio (RR) of each month compared to the annual mean. Results: The analysis included 317,586 and 23,789 events of IS/TIA and ICH respectively. We found an interaction between age and seasonality, accounting for a phase shift with age in the seasonal pattern of IS/TIA incidence. For cases under 70 years, the peak was during summertime and the RRs increased with decreasing age, reaching 1.11 (95% CI 1.09–1.13) at the youngest age group. In contrast, among the elderly, a winter peak was observed and the RRs increased with age to 1.07 (95% CI 1.06–1.08) at the oldest age group. For ICH, a winter/autumn peak was identified and the RRs increased with age to 1.20 (95% CI 1.16–1.24). Conclusions: Our finding of age-dependent seasonal patterns in the occurrence of stroke, suggests closer monitoring of cardiovascular risk factors during wintertime among elderly individuals. The mechanism governing the seasonal phase shift with age in IS/TIA incidence, requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Age-dependent seasonality in the incidence of stroke: A 21-year population-based study

Libruder,

Yaari,

Fluss

et al. 2024

European Stroke Journal

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“…Seasonal uctuations have been documented for a variety of different diseases across a broad range of populations and climates. In particular cardiovascular [10,11] and cerebrovascular diseases [12,13] have shown a ´winter peak´ and through in summer. This has been attributed to changes in ambient temperature, as mentioned morbidities were negatively correlated to it.…”

Section: Discussionmentioning

confidence: 99%

Submacular Hemorrhages Show no Significant Seasonal Variations in a European Cohort

Storp¹,

Diener²,

Eter³

et al. 2023

Preprint

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Purpose: To investigate seasonal variations in the onset of acute submacular hemorrhages (SMHs) in a European population and analyze the influence of the seasons, arterial hypertension and intake of anticoagulatory/antiplatelet (AC/AP) medication on hemorrhage size. Methods: This retrospective, monocentric study included 164 eyes of 164 patients treated for acute SMH at the University Hospital Münster, Germany, between 01/01/2016 and 12/31/2021. Data on the day of occurrence, hemorrhage size and general patient characteristics were recorded. “Test for cyclic trends in incidence data” was applied to investigate seasonal variations in SMH incidence. Fisher’s exact test was used to investigate the influence of the seasons, arterial hypertension and intake of AC/AP medication on hemorrhage size. Results: Statistical analysis did not reveal significant seasonal variations in the occurrence of SMHs (p = 0.81). While the seasons and the presence of systemic arterial hypertension did not exert a significant influence, intake of AC/AP medication significantly affected the size of SMH (p = 0.03). Conclusion: In this European cohort no significant seasonal variations of SMHs were observed. However, in patients with risk factors, such as neovascular age-related macular degeneration (nAMD), the chance of an increase in hemorrhage size should be considered when initiating AC/AP therapy.

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Exposure to air pollution and its effect on ischemic strokes (EP-PARTICLES study)

Kuźma

Roszkowska

Święczkowski

et al. 2022

Sci Rep

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It is well known that exceeded levels of particulate matter in the air and other air pollutants harmfully affect the cardiovascular system. Empirical analyses of the effects of these factors on stroke incidence and mortality are still limited. The main objective of our analyses was to determine the association between short-term exposure to air pollutants and stroke incidence in non-industrial areas, more specifically in north-eastern Poland. To achieve this aim, we used data from the National Health Fund on patients hospitalized for stroke between 2011 and 2020 in the largest city of the region described as the Green Lungs of Poland. The pollution levels and atmospheric conditions data were obtained from the Provincial Inspectorate for Environmental Protection and the Institute of Meteorology and Water Management. Using daily data on hospitalizations, atmospheric conditions, and pollution, as well as ordered logistic regression models the hypotheses on the impact of weather and air pollution conditions on ischemic strokes were tested. The study group included 4838 patients, 45.6% of whom were male; the average patient age was approximately 74 years. The average concentrations of PM2.5 were 19.09 µg/m3, PM10 26.66 µg/m3 and CO 0.35 µg/m3. Analyses showed that an increase in PM2.5 and PM10 concentrations by 10 µg/m3 was associated with an increase in the incidence of stroke on the day of exposure (OR = 1.075, 95% CI 0.999–1.157, P = 0.053; OR = 1.056, 95% CI 1.004–1.110, P = 0.035) and the effect was even several times greater on the occurrence of a stroke event in general (PM2.5: OR = 1.120, 95% CI 1.013–1.237, P = 0.026; PM10: OR = 1.103, 95% CI 1.028–1.182, P = 0.006). Furthermore, a short-term (up to 3 days) effect of CO on stroke incidence was observed in the study area. An increase of 1 μg/m3 CO was associated with a lower incidence of stroke 2 days after the exposure (OR = 0.976, 95% CI 0.953–0.998, P = 0.037) and a higher incidence 3 days after the exposure (OR = 1.026, 95% CI 1.004–1.049, P = 0.022).

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Seasonal Variation in Incidence of Stroke in a General Population of 1.4 Million Japanese: The Shiga Stroke Registry

Cited by 9 publications

References 42 publications

Age-dependent seasonality in the incidence of stroke: A 21-year population-based study

Age-dependent seasonality in the incidence of stroke: A 21-year population-based study

Submacular Hemorrhages Show no Significant Seasonal Variations in a European Cohort

Exposure to air pollution and its effect on ischemic strokes (EP-PARTICLES study)

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