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(Stroke. 2004;35:420.)
© 2004 American Heart Association, Inc.

Original Contributions

Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland

The FINSTROKE Study

Juhani Sivenius, MD; Jaakko Tuomilehto, MD, PhD; Pirjo Immonen-Räihä, MD, PhD; Minna Kaarisalo, MD, PhD; Cinzia Sarti, MD, PhD; Jorma Torppa, MSc; Kari Kuulasmaa, MSc, PhD; Markku Mähönen, MD, PhD; Aapo Lehtonen, MD Veikko Salomaa, MD, PhD

From the University Hospital of Kuopio, Brain Research and Rehabilitation Center Neuron, Kuopio (J.S.); Department of Epidemiology and Health Promotion, KTL (National Public Health Institute), Helsinki (K.K., M.M., J.T., C.S., J.T., V.S.); Raisio Regional Hospital, University of Turku, Turku (P.I.-R.); Turku City Hospital, Turku (M.K.); and University of Turku, Department of Geriatrics, Turku (A.L), Finland.

Correspondence to Professor Juhani Sivenius, Kuopio University Hospital, PO Box 1627, FIN-70211 Kuopio, Finland. E-mail juhani.sivenius{at}fimnet.fi

Background and Purpose— The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997.

Methods— The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women.

Results— The rates of acute stroke events fell during the whole study period in both men and women. In both FINSTROKE areas combined, the average annual decline in the age-standardized incidence of first stroke events was 2.0% (95% confidence interval [CI], -2.8 to -1.2; P<0.001) among men and 1.7% (95% CI, -2.6 to -0.8; P<0.001) among women. The decline in the incidence of ischemic stroke was even steeper, 2.9%/y (95% CI, -4.9 to -1.1; P<0.001) among men and 3.1%/y (95% CI, -5.0 to -1.1; P<0.001) among women, whereas the incidence of intracerebral hemorrhage and subarachnoid hemorrhage did not change. Mortality from all stroke events declined in the FINSTROKE areas by 3.7%/y (95% CI, -5.3 to -2.0; P<0.001) among men and by 4.1%/y (95% CI, -5.9 to -2.4; P<0.001) among women. The 28-day case fatality of all stroke events also tended to decline, but the decline was of borderline statistical significance only (P=0.07 among men, P=0.05 among women).

Conclusions— Incidence and mortality of stroke events declined significantly in these 2 register areas in Finland during the 15-year period of 1983 to 1997.

Key Words: epidemiology • Finland • incidence • mortality • stroke

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