Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS

Abstract

Background and Purpose— Sex differences in stroke incidence over time were previously reported from the GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study). We aimed to determine whether these differences continued through 2015 and whether they were driven by particular age groups. Methods— Within the GCNKSS population of 1.3 million, incident (first ever) strokes among residents ≥20 years of age were ascertained at all local hospitals during 5 periods: July 1993 to June 1994 and calendar years 1999, 2005, 2010, and 2015. Out-of-hospital cases were sampled. Sex-specific incidence rates per 100 000 were adjusted for age and race and standardized to the 2010 US Census. Trends over time by sex were compared (overall and age stratified). Sex-specific case fatality rates were also reported. Bonferroni corrections were applied for multiple comparisons. Results— Over the 5 study periods, there were 9733 incident strokes (56.3% women). For women, there were 229 (95% CI, 215–242) per 100 000 incident strokes in 1993/1994 and 174 (95% CI, 163–185) in 2015 ( P <0.05), compared with 282 (95% CI, 263–301) in 1993/1994 to 211 (95% CI, 198–225) in 2015 ( P <0.05) in men. Incidence rates decreased between the first and last study periods in both sexes for IS but not for intracerebral hemorrhage or subarachnoid hemorrhage. Significant decreases in stroke incidence occurred between the first and last study periods for both sexes in the 65- to 84-year age group and men only in the ≥85-year age group; stroke incidence increased for men only in the 20- to 44-year age group. Conclusions— Overall stroke incidence decreased from the early 1990s to 2015 for both sexes. Future studies should continue close surveillance of sex differences in the 20- to 44-year and ≥85-year age groups, and future stroke prevention strategies should target strokes in the young- and middle-age groups, as well as intracerebral hemorrhage.

Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry

“…Interestingly, the men/women IRR vanished over time, and the excess of incidence in women was no longer statistically significant after 2003 (IRR = 0.88; 95% CI: 0.62–1.26, p = 0.24). A similar result was found in the Greater Cincinnati/Northern Kentucky Stroke Study that reported a women/men IRR of 1.30 (95% CI: 0.87–1.74) in 2005 that even reversed in 2015 (IRR = 0.82; 95% CI: 0.54–1.10) [17]. These trends could reflect a more important increase in the incidence of ischemic stroke in young men than in young women between the 90s and early 2000s, together with a slight decrease in women observed in the very recent years.…”

“…Hence, in the Greater Cincinnati/Northern Kentucky population-based study, higher incidence rates of ischemic stroke were noted in patients aged 20–54 years between 1993/94 and year 2005 [5]. In a more recent analysis, the authors reported a slight decrease in the incidence in women aged 20–44 years between 2005 and 2015 (from 35/100,000/year; 95% CI: 27–42, to 26/100,000/year; 95% CI: 19–32), contrasting to a stable incidence in men (from 27/100,000/year; 95% CI: 20–33, to 31/100,000/year; 95% CI: 24–38) [17]. No change was observed during the same period in patients aged 45–64 years.…”

Preferences of Young Stroke Survivors to Meet Their Unique Needs

“…Most studies report that stroke is more common among men, but women are more likely to become more disabled from stroke and have a higher death rate. 5 Strokes are more common in Black and Hispanic adults across all age groups, as compared to White adults. 6 People with the traditional stroke risk factors of high blood pressure, high cholesterol, diabetes, and smoking are at greater risk for stroke as well.…”

The Relationship Between Transthoracic Echocardiography Findings, Localization of Stroke, and Risk Factors in Patients With Ischemic Stroke

“…The most common localization of ischemic stroke is middle cerebral artery (MCA) territory. The anterior cerebral artery (ACA), vertebrobasilar artery (VBA), and the posterior cerebral artery (PCA), less frequently, maybe the reason for ischemic stroke 5 . There are many risk factors for ischemic stroke, including hypertension (HT), diabetes mellitus (DM), coronary heart diseases (CAD), congestive heart failure (CHF), smoking and alcohol consumption, hyperlipidemia (HPL), inappropriate diet, physical inactivity, abdominal obesity, and prosthetic heart valves.…”