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(Stroke. 2005;36:244.)
© 2005 American Heart Association, Inc.

Original Contributions

Trends in Fatal and Nonfatal Strokes Among Persons Aged 35 to 85 Years During 1991–2002 in Finland

Pia Pajunen, MD, PhD; Rauni Pääkkönen, MSc(Tech); Helena Hämäläinen, MD, PhD; Ilmo Keskimäki, MD, PhD; Tiina Laatikainen, MD, PhD; Marja Niemi, MD, PhD; Hannu Rintanen, MD, PhD Veikko Salomaa, MD, PhD

From the KTL/National Public Health Institute, Helsinki (P.P., R.P., T.L., V.S.); Social Insurance Institution, Turku (H.H.); and National Research and Development Centre for Welfare and Health, Helsinki (I.K., M.N., H.R.), Finland.

Correspondence to Dr Veikko Salomaa, Department of Epidemiology and Health Promotion, National Public Health Institute, FI-00300 Helsinki, Finland. E-mail veikko.salomaa{at}ktl.fi

Background and Purpose— Declining trends in the incidence and mortality of stroke have been observed in Finland since the beginning of the 1980s until 1997. In this study we analyzed the trends in fatal and nonfatal strokes in Finland during 1991–2002.

Methods— The Finnish Hospital Discharge Register was linked to the National Causes of Death Register to produce a Cardiovascular Disease Register, which includes data on 410 760 cerebrovascular events (International Statistical Classification of Diseases, 10th Revision [ICD-10] codes I60–I69) in patients aged 35 years in 1991–2002.

Results— Age-standardized incidence of first-ever stroke (ICD-10 codes I60–I64, excluding I63.6) per 100 000 persons declined during 1991–2002 annually by 2.2% (95% CI, –2.4% to –1.9%) among men and 2.5% (–2.8% to –2.2%) among women aged 35 to 74 years. In patients aged 75 to 84 years, the change in the incidence of first-ever stroke was –2.6% per year (–3.0% to –2.2%) among men and –3.2% per year (–3.5% to –2.9%) among women. A similar trend was observed also in the oldest age group, in patients aged 85 years. Among patients aged 35 to 74 years, the 28-day case fatality of first-ever stroke declined annually by 3.2% (–3.9% to –2.5%) among men and by 3.0% (–3.8% to –2.2%) among women. A significant decrease was found in the 28-day case fatalities of all subtypes of stroke in this age group.

Conclusions— The favorable development in stroke incidence, mortality, and case-fatality has continued in Finland during 1991–2002.

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

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