title: Trends of Stroke Incidence from 1995 to 2013 in Joinville, Brazil.
abstract: Temporal trends on the incidence of stroke and its subtypes could help assess on-going public health policies and point to further targets for action among middle- and low-income countries, where the stroke burden is very high. This study aimed at evaluating longitudinal trends of stroke incidence in Joinville, Brazil.
  
  
  
  We ascertained the incidence of all first-ever strokes occurred in 1995, 2005-2006 and 2012-2013, which were extracted from Joinville Stroke Registry, a prospective epidemiological data bank, launched in 1995.
  
  
  
  From 1995 to 2013, the age-adjusted incidence of all strokes decreased 37% (95% CI 32-42). From 2005 to 2013, the haemorrhagic stroke (HS) incidence decreased 60% (95% CI 13-86), ischemic stroke (IS) incidence decreased 15% (95% CI 1-28), and subarachnoid haemorrhage incidence remained stable. The proportion of IS and HS patients with regularly treated hypertension increased by 60% (p = 0.01) and 33% (p = 0.01), respectively. The proportion of IS and HS patients that quit smoking increased 8% (p = 0.03) and 17% (p = 0.03), respectively.
  
  
  
  Stroke incidence has been decreasing in Joinville over the last 18 years, more so for HS than IS. Better control of hypertension and tobacco use might explain these findings.
authors.affiliation: Joinville Stroke Registry, Joinville, Brazil.
authors.forename: Norberto L
authors.initials: NL
authors.lastname: Cabral
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Cougo-Pinto
authors.forename: Pedro S C
authors.initials: PS
authors.lastname: Magalhaes
authors.forename: Alexandre L
authors.initials: AL
authors.lastname: Longo
authors.forename: Carla H C
authors.initials: CH
authors.lastname: Moro
authors.forename: Claudio H
authors.initials: CH
authors.lastname: Amaral
authors.forename: Gerson
authors.initials: G
authors.lastname: Costa
authors.forename: Felipe I
authors.initials: FI
authors.lastname: Reis
authors.forename: Anderson R R
authors.initials: AR
authors.lastname: Gonçalves
authors.forename: Vivian
authors.initials: V
authors.lastname: Nagel
authors.forename: Octavio M
authors.initials: OM
authors.lastname: Pontes-Neto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult