Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study.
OBJECTIVE
The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997.


METHODS
The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women.


RESULTS
The rates of acute stroke events fell during the whole study period in both men and women. In both FINSTROKE areas combined, the average annual decline in the age-standardized incidence of first stroke events was 2.0% (95% confidence interval [CI], -2.8 to -1.2; P<0.001) among men and 1.7% (95% CI, -2.6 to -0.8; P<0.001) among women. The decline in the incidence of ischemic stroke was even steeper, 2.9%/y (95% CI, -4.9 to -1.1; P<0.001) among men and 3.1%/y (95% CI, -5.0 to -1.1; P<0.001) among women, whereas the incidence of intracerebral hemorrhage and subarachnoid hemorrhage did not change. Mortality from all stroke events declined in the FINSTROKE areas by 3.7%/y (95% CI, -5.3 to -2.0; P<0.001) among men and by 4.1%/y (95% CI, -5.9 to -2.4; P<0.001) among women. The 28-day case fatality of all stroke events also tended to decline, but the decline was of borderline statistical significance only (P=0.07 among men, P=0.05 among women).


CONCLUSIONS
Incidence and mortality of stroke events declined significantly in these 2 register areas in Finland during the 15-year period of 1983 to 1997.
Sivenius
Juhani
J
University Hospital of Kuopio, Brain Research and Rehabilitation Center Neuron, Kuopio, Finland. juhani.sivenius@fimnet.fi
Tuomilehto
Jaakko
J
Immonen-Räihä
Pirjo
P
Kaarisalo
Minna
M
Sarti
Cinzia
C
Torppa
Jorma
J
Kuulasmaa
Kari
K
Mähönen
Markku
M
Lehtonen
Aapo
A
Salomaa
Veikko
V
D000328:Adult; D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012042:Registries / Q000706:statistics & numerical data; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*