title: Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study.
abstract: 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.
authors.affiliation: University Hospital of Kuopio, Brain Research and Rehabilitation Center Neuron, Kuopio, Finland. juhani.sivenius@fimnet.fi
authors.forename: Juhani
authors.initials: J
authors.lastname: Sivenius
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Pirjo
authors.initials: P
authors.lastname: Immonen-Räihä
authors.forename: Minna
authors.initials: M
authors.lastname: Kaarisalo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Sarti
authors.forename: Jorma
authors.initials: J
authors.lastname: Torppa
authors.forename: Kari
authors.initials: K
authors.lastname: Kuulasmaa
authors.forename: Markku
authors.initials: M
authors.lastname: Mähönen
authors.forename: Aapo
authors.initials: A
authors.lastname: Lehtonen
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
mesh_terms: 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*