Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004

Abstract

Background and Purpose-With the progress in stroke prevention, it is important to evaluate the epidemiological trends of strokes over a long period and from a nonselected population-based perspective. Methods-We estimated changes in incidence, case-fatality rates, severity, risk factors and prestroke use of preventive treatments for first-ever strokes, from a continuous 20-year well-defined population-based registry, from 1985 to 2004. Results-We recorded 3142 ischemic strokes, 341 primary cerebral hemorrhages and 74 subarachnoid hemorrhages.During the 20-year study, the age at first stroke onset increased by 5 years in men and 8 years in women. Comparing the 1985 to 1989 and the 2000 to 2004 periods, age-and sex-standardized incidences of first-ever strokes were stable except for lacunar strokes whose incidence significantly increased (Pϭ0.01) and for cardioembolic stroke whose incidence significantly decreased (Pϭ0.01). Twenty-eight-day case-fatality rates decreased significantly mainly for lacunar strokes (Pϭ0.05) and for primary cerebral hemorrhages (Pϭ0.03). The proportion of hypercholesterolemia and diabetes significantly increased (PϽ0.01). In contrast, the proportion of myocardial infarction significantly decreased (Pϭ0.02). Prestroke antiplatelets and anticoagulants treatment significantly increased (PϽ0.01). Conclusions-The age-and sex-standardized incidences of first strokes in Dijon have been stable over the past 20 years and were associated with an increase in age at stroke onset, a decrease in case-fatality rates, and an increased use of antiplatelet treatments.

Age and Ethnic Disparities in Incidence of Stroke Over Time

“…Other possible explanations for ethnic disparities include cultural differences in perceptions of health and the health care system, environmental exposures, genetic factors, socioeconomic status, and educational attainment. 2 Our results seem similar to findings from previous studies of trends in beforestroke risk factors based on either a mainly white population 8,24 or a multiethnic population, 4,9 except that we did not find a significant reduction in hypertension in white groups in this inner-city population.…”

Systemic chemokine levels, coronary heart disease, and ischemic stroke events

“…24,25 The higher incidence rate of IS in Northern Irish than in French men in PRIME is also consistent with the north to south gradient of IS in Europe. The age range of 50 to 59 years may also explain the apparent disproportional ratio between CHD and ischemic stroke rates in PRIME.…”

Trends in the Incidence and Survival of Intracerebral Hemorrhage by its Location in a Japanese Community

“…12 A study in the United Kingdom found that the ICH incidence fell in the younger population, with no definite change in the older subjects between 1981 and 2006. 13 In contrast, the ICH incidence was stable in France (between 1985 and 2004) 14 and in the United States (between 1993 and 1999). 15 None of these studies observed the ICH incidence before the 1970 s when brain imaging was not in practical use.…”