title: [Trends in stroke incidence and case-fatality rates over a 20-year period (1985-2004) in Dijon, France].
abstract: With progress in stroke prevention it is important to evaluate epidemiological trends over a long period and in an unselected population. We estimated changes in stroke incidence, the case-fatality rate, risk factors, and the use of primary prevention, based on a continuous registry of a well-defined population, from 1985 to 2004. We recorded 3142 ischemic strokes, 341 primary cerebral hemorrhages and 74 subarachnoid hemorrhages. During the 20-year study period, age at first stroke increased by 5 years in men and 8 years in women. Comparing the periods 1985-1989 and 2000-2004, the age - and sex-adjusted incidence rates of first-ever strokes were stable, except for lacunar strokes, the incidence of which increased significantly (p = 0.05), and also cardio-embolic stroke, the incidence of which fell significantly (p = 0.01). Twenty-eight-day case-fatality rates fell significantly, especially for lacunar stroke (p = 0.05) and primary cerebral hemorrhage (p = 0.03). The frequency of hypercholesterolemia and diabetes increased significantly (p < 0.01). In contrast, the frequency of myocardial infarction fell significantly (p = 0.02). The frequency of smoking and diastolic blood pressure J 90 mmHg also fell, but the difference was not significant because of missing data. The frequency of pre-stroke antiplatelet and anticoagulant treatment increased significantly (p < 0.01). The age - and sex-adjusted incidence rates of stroke in Dijon, France, have thus been stable for the past 20 years. Age at stroke onset has increased, the case-fatality rate has fallen, antiplatelet treatment is more frequent, and the frequency of some pre-stroke risk factors has fallen.
authors.affiliation: Registre dijonnais des AVC, Neurologie de Dijon - Laboratoire associé à 1'Inserm et à l'Invs.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Bejot
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.forename: Isabelle
authors.initials: I
authors.lastname: Benatru
authors.forename: Thibault
authors.initials: T
authors.lastname: Moreau
authors.forename: Marc
authors.initials: M
authors.lastname: Freycz
authors.forename: Guy Victor
authors.initials: GV
authors.lastname: Osseby
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D003627:Data Interpretation, Statistical; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011322:Primary Prevention; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology