Stroke Prevention in New Zealand: Can We Do Better?

Feigin, Valery L.; Krishnamurthi, Rita; Barber, P. Alan; Arroll, Bruce

doi:10.1111/ijs.12117

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…[ 4 , 74 – 79 ] Furthermore, a detailed analysis of recent changes in stroke risk factors is needed to explain the diverging trends in stroke incidence and mortality rates in the different ethnic groups in NZ and to further inform culturally appropriate primary stroke prevention strategies. [ 80 ]…”

Section: Discussionmentioning

confidence: 99%

30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies

et al. 2015

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BackgroundInsufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years.MethodsFour stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years) of Auckland NZ in 1981–1982, 1991–1992, 2002–2003 and 2011–2012. All used standard World Health Organization (WHO) diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard) annual incidence and mortality with corresponding 95% confidence intervals (CI) were calculated per 100,000 people, assuming a Poisson distribution.Results5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31%) and 62% (95% CI 36%-86%), respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively) compared with NZ/Europeans (mean age 75 years). There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17%) across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in frequency of current smoking among stroke patients.ConclusionsIn this unique temporal series of studies spanning 30 years, stroke incidence, early case-fatality and 1-year mortality have declined, but ethnic disparities in risk and outcome for stroke persisted suggesting that primary stroke prevention remains crucial to reducing the burden of this disease.

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Section: Discussionmentioning

confidence: 99%

30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies

et al. 2015

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“…There are long-term costs of stroke, with financial benefits from reducing evidence-practice gaps in acute stroke care, including acute thrombolysis and stroke unit care [26-29]. The focus may need to be on primary prevention , especially blood pressure control [30, 31].…”

Section: Resultsmentioning

confidence: 99%

Stroke Epidemiology in Oceania: A Review

Venketasubramanian

2021

Neuroepidemiology

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Background and Purpose: Oceania, comprising the regions Australasia, Melanesia, Micronesia, and Polynesia, is home to 42 million living in 8.5 million square kilometres of land. This paper comprises a review of the epidemiology of stroke in countries in this region. Methods: Information on epidemiology of stroke in Oceania was sought from data from the Global Burden of Disease (GBD) study (incidence, mortality, incidence:mortality ratio [IMR], prevalence, disability-adjusted life-years [DALYs] lost due to stroke, and subtypes), World Health Organization (WHO) (vascular risk factors in the community), and PubMed (incidence, prevalence, and stroke subtypes). Data were analyzed by region to allow inter-country comparison within each region. Results: In 2010, age- and sex-standardized stroke mortality rates were lowest in Australasia (29.85–31.67/100,000) and highest in Melanesia and Micronesia (56.04–187.56/100,000), with wide ranges especially in Melanesia. Incidence rates were lowest in Australasia (101.36–105.54/100,000), similarly high elsewhere. Standardized IMR (0.98–3.39) was the inverse of the mortality rates and mirrored the prevalence rates (202.91–522.29/100,000). DALY rates (398.22–3,781.78/100,0000) mirrored the mortality rates. Stroke risk factors show a variable pattern – hypertension is generally the most common medical risk factor among males (18.0–26.6%), while among females, diabetes mellitus is the most common in Micronesia and Polynesia (21.5–28.4%). Among the lifestyle factors, current smoking is the most common in Melanesia among males, while obesity is generally the most common factor among females. Ischaemic stroke comprises 70% of stroke subtypes. Trend data show significant falls in standardized mortality rates and DALYs in most regions and falls in incidence in almost all countries. There is significant economic impact, particularly due to young strokes; some ethnicities are at higher risk than others, for example, Maoris and Pacific Islanders. Conclusions: Stroke is a major healthcare problem in Oceania. Variations in stroke epidemiology are found between countries in Oceania. Data are lacking in some; more research into the burden of stroke in Oceania is needed. With the expected increase in life expectancy and vascular risk factors, the burden of stroke in Oceania will likely rise. Some of the disparities in stroke burden may be addressed by great investment in healthcare.

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“…E esta pode estar associada a tendências significativas na redução de ocorrência do AVC e prevalência dos fatores de risco na população. Assim sendo, o se identificar lacunas no conhecimento sobre AVC, fatores de risco e sintomas em grandes grupos étnicos, futuras intervenções culturalmente apropriadas para programas educativos preventivos poderiam ser informadas (FEIGIN, 2014).…”

Section: Resultsunclassified

Fragilidade Em Idosos Segundo Classificação Internacional De Funcionalidade, Incapacidade E Saúde

Souza¹,

Vilela²,

Mesquita³

et al. 2020

Fisioterapia Na Atenção À Saúde 3

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Direitos para esta edição cedidos à Atena Editora pelos autores.Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.A Atena Editora não se responsabiliza por eventuais mudanças ocorridas nos endereços convencionais ou eletrônicos citados nesta obra.Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação.

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Stroke Prevention in New Zealand: Can We Do Better?

Cited by 8 publications

References 26 publications

30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies

30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies

Stroke Epidemiology in Oceania: A Review

Fragilidade Em Idosos Segundo Classificação Internacional De Funcionalidade, Incapacidade E Saúde

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