title: Temporal Trends in Sex Differences With Regard to Stroke Incidence: The Dijon Stroke Registry (1987-2012).
abstract: OBJECTIVE
  We evaluated temporal trends in stroke incidence between men and women to determine whether changes in the distribution of vascular risk factors have influenced sex differences in stroke epidemiology.
  
  
  METHODS
  Patients with first-ever stroke including ischemic stroke, spontaneous intracerebral hemorrhage, subarachnoid hemorrhage, and undetermined stroke between 1987 and 2012 were identified through the population-based registry of Dijon, France. Incidence rates were calculated for age groups, sex, and stroke subtypes. Sex differences and temporal trends (according to 5-year time periods) were evaluated by calculating incidence rate ratios (IRRs) with Poisson regression.
  
  
  RESULTS
  Four thousand six hundred and fourteen patients with a first-ever stroke (53.1% women) were recorded. Incidence was lower in women than in men (112 versus 166 per 100 000/y; IRR, 0.68;P<0.001), especially in age group 45 to 84 years, and for both ischemic stroke and intracerebral hemorrhage. From 1987 to 2012, the lower incidence of overall stroke in women was stable (IRR ranging between 0.63 and 0.72 according to study periods). When considering stroke subtype, a slight increase in the incidence of ischemic stroke was observed in both men (IRR, 1.011; 95% confidence interval, 1.005-1.016;P=0.001) and women (IRR, 1.013; 95% confidence interval, 1.007-1.018;P=0.001). The sex gap in incidence remained unchanged in ischemic stroke and intracerebral hemorrhage. Conversely, the lower subarachnoid hemorrhage incidence in women vanished with time because of an increasing incidence.
  
  
  CONCLUSIONS
  The sex gap in stroke incidence did not change with time except for subarachnoid hemorrhage. Despite lower rates, more women than men experience an incident stroke each year because of a longer life expectancy.
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Marie
authors.initials: M
authors.lastname: Giroud
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Benoit
authors.initials: B
authors.lastname: Delpont
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Benoit
authors.initials: B
authors.lastname: Daubail
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Christelle
authors.initials: C
authors.lastname: Blanc
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Jérôme
authors.initials: J
authors.lastname: Durier
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud).
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.affiliation: From the Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Burgundy, France (Marie Giroud, B. Delpont, B. Daubail, C.B., J.D., Maurice Giroud, Y.B.); and Department of Neurology, CH William Morey, Chalon-sur-Saône, France (Marie Giroud). ybejot@yahoo.fr.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*
keywords: epidemiology; incidence; income; registry; stroke