Stroke surveillance: population-based estimates and projections for New Zealand.
OBJECTIVE
To estimate the incidence, prevalence and mortality of stroke in New Zealand (NZ) in 2001, projected to 2011.


METHODS
Multistate lifetable models were constructed using smoothed rates of first-ever stroke incidence and relative risks of mortality estimated from the most recent Auckland Regional Community Stroke (ARCOS) Study. Estimates of the burden of stroke in NZ were calculated by applying rates output by the model to the 2001 population. Stroke incidence, prevalence and mortality were then projected to 2011, assuming similar trends in stroke incidence and case fatality to those estimated between the 1991/92 and 2002/03 studies.


RESULTS
A total of 5,200 first-ever strokes were estimated to have occurred in NZ in 2001. Rates of stroke rose exponentially with increasing age and were 20% higher among males than females at most ages. Nevertheless, the lifetable risk of stroke was lower for males (16%) than females (18%). On average, males survived a year longer than females after a first-ever stroke (9.0 vs. 8.2 years). The incidence rates of first-ever stroke declined by approximately 1% per year between 1991 and 2003. The lifetable risk of stroke remained stable for females but increased for males (from 14% to 16%) over this period. Stroke prevalence also increased by approximately 1% per year, whereas stroke-related mortality fell by 4% per year. If these trends continue, approximately 6,000 first-ever strokes (2% annual increase), 45,000 stroke survivors (2% annual increase) and 2,000 stroke-related deaths (1% annual decline) are expected in 2011.


CONCLUSIONS
Stroke mortality is falling faster than stroke incidence. This, together with population growth and ageing, will lead to a rising burden of stroke-related disability over the next decade.
Tobias
Martin
M
Public Health Intelligence, New Zealand Ministry of Health, Wellington, New Zealand. martin_tobias@moh.govt.nz
Cheung
Jit
J
Carter
Kristie
K
Anderson
Craig
C
Feigin
Valery L
VL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality