Stroke, Vol 22, 7-11, Copyright © 1991 by American Heart Association
J Tuomilehto, R Bonita, A Stewart, A Nissinen and JT Salonen
Finland has high rates of both cardiovascular disease and cardiovascular
disease risk factors. We studied random samples of the population 30-59
years of age for risk factors in two provinces of eastern Finland in 1972
and 1977. We then followed both cohorts until 1985 through linkage with
national hospital discharge and death certificate registers. The prevalence
of hypertension and smoking in both provinces declined between 1972 and
1977, as did the stroke incidence in the 8-year period of follow-up of each
cohort. We observed no differences in stroke incidence between the two
provinces. The relative risk of stroke in the later period (1977-1985) was
0.71 and 0.58 for men and women, respectively, when compared with the
earlier period (1972-1980). Overall, 28% of all stroke events could be
attributed to hypertension, 17% to smoking, and 43% to these two factors
jointly. The decrease in the prevalence of hypertension and smoking
accounted for about 29% of the decline.
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Hypertension, cigarette smoking, and the decline in stroke incidence in eastern Finland
National Public Health Institute, Helsinki, Finland.
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