(Stroke. 1995;26:361-367.)
© 1995 American Heart Association, Inc.
Articles |
Stroke Incidence, Case Fatality, and Mortality in the WHO MONICA Project
From the WHO MONICA Project Annex; Glostrup Population Studies, Glostrup University Hospital (P.T., M.S.) (Denmark); the Department of Medicine, Umeå University (K.A.) (Sweden); and the MONICA Data Center, Department of Epidemiology and Health Promotion, National Public Health Institute (K.K., A.-M.R.), Helsinki, Finland.
Correspondence to Dr Per Thorvaldsen, Glostrup Population Studies, Glostrup University Hospital, DK-2600 Glostrup, Denmark.
 |
Abstract |
|---|
 Top Abstract IntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
Background and Purpose This report compares stroke incidence, case fatality, and mortality rates during the first years of the WHO MONICA Project in 16 European and 2 Asian populations.
Methods In the stroke component of the WHO MONICA Project, stroke registers were established with uniform and standardized rules for case ascertainment and validation of events.
Results A total of 13 597 stroke events were registered from 1985 through 1987 in a total background population of 2.9 million people aged 35 to 64 years. Age-standardized stroke incidence rates per 100 000 varied from 101 to 285 in men and from 47 to 198 in women. The combined stroke attack rates for first and recurrent events were approximately 20% higher than incidence rates in most populations and varied to the same extent. Stroke incidence rates were very high among the population of Finnish men tested. The incidence of stroke was, in general, higher among populations in eastern than in western Europe. It was also relatively high in the Chinese population studied, particularly among women. The case-fatality rates at 28 days varied from 15% to 49% among men and from 18% to 57% among women. In half of the populations studied, there were only minor differences between official stroke mortality rates and rates measured on the basis of fatal events registered and validated for the WHO MONICA stroke study.
Conclusions The WHO MONICA Project provides a unique opportunity to perform cross-sectional and longitudinal comparisons of stroke epidemiology in many populations. The present data show how large differences in stroke incidence and case-fatality rates contribute to the more than threefold differences in stroke mortality rates among populations.
Key Words: cerebrovascular disorders • epidemiology • incidence • mortality
|
Introduction |
|---|
|
TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
The WHO MONICA (World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease) Project1 2 was initiated in the early 1980s. The aim was to continuously register the occurrence of myocardial infarction and stroke among many populations and to analyze the relation between temporal trends in incidence and mortality rates and changes in major cardiovascular risk factors over time. By use of uniform procedures and methods, stroke event rates were monitored for a 10-year period. Core data for each event were collected and analyzed at the WHO MONICA Data Center in Helsinki, Finland.
In stroke epidemiology, official mortality statistics have long been the most commonly used source for multinational comparisons,3 4 5 6 7 and they are still the source that permits comparisons across the most countries and continents. But the validity of routine statistics has been questioned. Death-certificate coding may vary between countries, and because case-fatality rates vary8 the numbers of cerebrovascular deaths do not uniformly reflect the numbers of stroke survivors and the total burden of stroke in a population.
Stroke registers can provide more accurate estimates of incidence and mortality rates than official routine statistics.9 Data on stroke incidence are widely available10 from community-based stroke studies11 12 13 14 15 and cohort studies16 17 in many countries. These have contributed valuable information on temporal trends within the populations under study, but differences in study design limit the possibilities for comparisons across populations. Exceptions to this are the WHO collaborative study on stroke in the community18 and more recent studies with WHO MONICA criteria for case ascertainment and classification of stroke events.19 20 21 22 23 24
This article compares stroke incidence, case fatality, and mortality rates at baseline among 18 populations in 10 countries for the WHO MONICA Project.
|
Subjects and Methods |
|---|
|
TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
MONICA Populations
Between 1982 and 1986, 19 of 39 MONICA Collaborating Centers (MCCs) entered the stroke component of the MONICA Project. Four MCCs withdrew from the stroke study after a few years of registration, mainly because of lack of funding and failure to ensure complete coverage. Since some of the remaining 15 MCCs cover more than one study population, the stroke component of the WHO MONICA Project involves 21 populations in 11 countries. Data from three populations (two in Hungary and one in Russia) were omitted from the present comparison because validations of case ascertainment were not completed by the time the data were compiled.
Table 1
shows the average midyear population of men and
women aged 35 to 64 years, obtained from population registers,
censuses, or intercensus estimates for calendar years 1985 through
1987. The total study population was 2.9 million people. Detailed
information on how MONICA populations are defined is given
elsewhere.1 2
|
The protocol for the stroke registers provided detailed instructions for event registration. It included guidelines for case ascertainment, outlined validation procedures, and gave specific coding rules for diagnostic category (definite stroke, unclassifiable, or not stroke), order of event (first or recurrent), and case-fatality rate. Local validations of registration procedures were undertaken because registrations were implemented within widely different health services systems, and, thus, adjustments were required locally by practical, ethical, and medicolegal demands.
Definitions of Stroke and Diagnostic Categories
Stroke was defined as rapidly developed signs of focal (or
global) disturbance of cerebral function lasting >24 hours (unless
interrupted by surgery or death), with no apparent nonvascular cause;
this category included patients presenting with clinical signs and
symptoms suggestive of subarachnoid hemorrhage, intracerebral
hemorrhage, or cerebral ischemic infarction. Hence, the study is based
on clinical diagnoses, which have been shown to be
reliable.25 During the years covered by this report,
diagnostic procedures permitting valid classification of stroke
subtypes (eg, neuroimaging) were available to only a limited extent in
several populations and not at all in some.
The WHO MONICA Project is concerned with events, not persons. Events are classified as first or recurrent and as fatal or nonfatal. A period of 28 days was used to define the case-fatality rate and to distinguish between events. Diagnostic criteria were applied to symptoms, clinical findings, and investigations undertaken within 28 days of onset. Transient ischemic attacks and silent brain infarctions (cases without clinical symptoms or signs) were not included. Neither were events associated with trauma, blood disease, or malignancy.
Events were categorized as "definite stroke," "not stroke," or "unclassifiable." Criteria for definite stroke were fulfilled when the available information permitted a clinical diagnosis of stroke. Unclassifiable was used when no diagnosis other than stroke was present to explain the event but the available information was insufficient for determining whether symptoms and duration fully met the MONICA criteria for definite stroke. The term unclassifiable was, with few exceptions, restricted to fatal events.
Case Ascertainment
All events that occurred in the study population were registered
and assigned to a diagnostic category, irrespective of survival status
and place of occurrence and management. Death certificates were the
major source of identification for fatal events. All death certificates
with an International Classification of Diseases (ICD) code of 430 to
434 or 436 were registered and validated according to MONICA criteria.
The MCCs used the eighth or ninth revised version of the ICD; both
these versions use the same codes for acute cerebrovascular diseases,
including codes for subarachnoid hemorrhage, intracerebral
hemorrhage, thromboembolic ischemic brain infarction, and ill-defined
stroke. In most centers, death certificates within a wider range of ICD
codes were scrutinized because diagnoses other than acute stroke also
indicated stroke events categorized as definite or unclassifiable
according to MONICA criteria.
Hospitalized patients were identified from hospital admission lists ("hot pursuit") or discharge diagnoses ("cold pursuit"). All ICD codes from 430 to 434 and code 436 were searched and validated. A wider range of diagnoses was required for the initial part of the study; diagnoses that did not contribute to the registration were subsequently omitted from the search profile.
Events were validated on the basis of medical records specific to the admission relating to the event. Records from previous admissions, outpatient clinics, and other medical services were scrutinized when available and pertinent to the determination of diagnostic category or order of event.
For identification and validation of cases managed outside the hospital, various procedures adjusted to conform with local conditions were applied. The main source of information was general practitioners, who reported cases managed at home or in institutions other than hospitals, either spontaneously or on request from the MONICA team.
Statistical Methods
The term "stroke attack rate" refers to both first and
recurrent events (all strokes), whereas "incidence rate" is
restricted to only the first stroke. "Case fatality rate" is
defined as the proportion of events that are fatal within 28 days of
onset. "Mortality rate" is the number of fatal events that occurs
within 28 days per a population of 100 000 people.
Age-standardized stroke attack, incidence, and mortality rates were calculated on the basis of patients ranging from 35 to 64 years old divided into groups according to age (5 years per group): 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, and 60 to 64 years old. Weights of 6, 6, 6, 5, 4, and 4, respectively, were derived for each group from the age distribution of Segi's world population.26
Age-standardized case-fatality rates were calculated on the basis of
10-year age groups of 35 to 44, 45 to 54, and 55 to 64 years old, with
weights of 1, 3, and 7, respectively, reflecting the age distribution
of all stroke events. Confidence intervals were calculated with the
relation between Poisson and 
2 distributions to
derive confidence intervals for weighted sums of Poisson
parameters.27
For this article, small study populations in some MCCs were combined to obtain sufficiently large numbers of events for stable descriptive statistics.
Data Quality
A range of quality-control measures for data collection
procedures and coding practices was introduced. Series of test-case
histories were circulated and completed by the MCCs for evaluation of
coding practice.28 Data submitted to the MONICA Data
Center were checked for completeness, logical consistency, and deviant
distributions of key variables. Registration of fatal events was
assessed for completeness by comparison with official mortality
statistics for the MONICA populations. No uniform external source was
available for nonfatal events. Assessment of the completeness of
registration included detailed checking and explanations of any deviant
distributions from the MCCs concerned. Details of the data quality
assessment have been reported elsewhere.29
|
Results |
|---|
|
TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
In men and women aged 35 to 64 years, 13 597 total definite and unclassifiable stroke events occurred from 1985 to 1987. The numbers of events by sex and population and the percentages of events classified as definite, recurrent, or fatal are shown in Table 2
.
|
Overall, <1% of all nonfatal events was unclassifiable. This proportion did not exceed 5% in any population, and in 11 populations no such events were recorded. The proportion of unclassifiable fatal events was >10% in populations from the former East Germany (German Democratic Republic) and West Germany (Federal Republic of Germany) and was as much as one fifth in the Warsaw, Poland, and both Moscow, Russian Federation, populations. In the remaining populations, this proportion was <10%.
The median proportion of recurrent stroke among populations was 20%,
ranging from 8% in Göteborg, Sweden, to 26% in Beijing, China
(Table 2
). In nine MONICA populations, this proportion was between 18%
and 22%. The proportion of nonfatal events of unknown order (first or
recurrent) was <2% on average and <5% in all populations.
Approximately one third of the fatal events were of unknown order among
the Göteborg population, the two Moscow populations, and the
Warsaw population, but this proportion did not exceed one fifth in the
remaining 14 populations.
The average annual stroke attack rates for first and recurrent strokes
are shown in Table 3. There was a threefold differential
among men in the population with the highest stroke attack rate
(Kuopio, Finland) versus those in the population with the lowest stroke
attack rate (Friuli, Italy). In women, the stroke attack rate was five
times higher in the population from Novosibirsk, Russian Federation,
than that from the Rhein-Neckar region of Germany (formerly part of
West Germany). If the Novosibirsk population is disregarded, the
variation among populations was the same for men and women. In general,
stroke attack rates were lower in western than in eastern Europe for
both men and women.
|
Fig 1 shows age-standardized incidence rates for
definite first occurrences of stroke. The range of variation for
incidence rates between populations and geographical distribution was
not substantially different from that of stroke attack rates.
|
Stroke attack and incidence rates were higher among men than women in all populations. The ratio of men to women for age-standardized incidence rates varied from 1.2 in Novosibirsk to 2.4 in North Karelia, Finland. In six populations, the rates among men were more than twice those among women.
Table 4 shows incidence rates for definite stroke
according to 10-year age groups, population, and sex. Stroke incidence
rates increased steeply with age in all populations.
|
The average case-fatality rate at 28 days was 30% and varied threefold
among populations, ranging from 15% to 49% among men and from 18% to
57% among women (Table 2). The lowest case-fatality rates were
reported from populations in the Nordic countries (Denmark, Finland,
and Sweden), West Germany, Lithuania, and Novosibirsk, Russian
Federation, whereas case-fatality rates were high in most of the
eastern European populations (that of Warsaw, Poland, in particular)
and in Italy. Case fatality rates were higher among women than men in
all populations except the Kaunas, Lithuania, and the Novosibirsk
populations.
Data submitted to the MONICA Data Center included the official numbers of cerebrovascular deaths (ICD codes 430 to 438), which were derived from routine statistics and reported by population, sex, and age group.
Age-standardized mortality rates calculated on the basis of fatal
events validated and registered for the WHO MONICA Project were similar
to official routine mortality rates for the same age ranges among most
MONICA populations (Fig 2). In some populations, the
official mortality rates were notably higher than the rates based on
MONICA criteria. Among the three MONICA populations in the former East
Germany, official mortality rates were lower than those derived by use
of MONICA criteria.
|
|
Discussion |
|---|
|
TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
The present cross-sectional study, done at baseline for the WHO MONICA Project, has demonstrated differences in stroke incidence and case-fatality rates of greater than threefold between populations. This study also has shown that official mortality statistics on stroke are reliable in several countries. Our observations support the observations of marked variations in stroke mortality rates reported in previous multinational comparisons.
The present study comprises only two populations outside Europe and is therefore geographically more limited than the previous WHO study on stroke18 and other comparisons of stroke incidence10 and of official mortality statistics.3 4 5 6 7 Within the present geographic range, a pattern is recognized, with very high attack, incidence, and mortality rates among the Finnish population studied and with higher attack, incidence, and mortality rates among the populations of eastern Europe than among those in western Europe. These results agree with those from studies of stroke mortality based on routine statistics, and the geographic distribution for these rates resembles that for rates of coronary heart disease morbidity and mortality.30
High 28-day case-fatality rates combined with relatively low stroke attack rates were seen in two populations (those in Warsaw, Poland, and Friuli, Italy) suggesting incomplete coverage of nonfatal cases. However, detailed validations in both centers failed to document substantial numbers of events not ascertained by the WHO MONICA registers.29
Death certificates were scrutinized in all populations. In addition to this, sources identifying the stroke onset (eg, hospital records) also indicated fatal events. Consequently, the registration of fatal events was probably less sensitive to differences among case-finding procedures, since many such events were retrievable from more than one source. On the other hand, fatal events were more often than nonfatal events unclassifiable or of unknown order. Thus, the precision of the estimates for fatal events was influenced by the quality of the available information, whereas the estimates of nonfatal events were more sensitive to case ascertainment procedures per se.
In several populations, the stroke mortality rate calculated from official routine statistics was higher than that measured by the stroke registers. This may be due in part to more deaths being attributed to cerebrovascular disease (stroke or late sequelae of stroke) after the 28th day of stroke onset or to an excess number of cases that for other reasons did not fulfill MONICA criteria for stroke. Obviously, less-specific criteria will permit a larger contingency. This may be of particular relevance for the high mortality figures previously reported from the population in China. In China, autopsy is rarely performed (WHO MONICA Project, unpublished data, 1994); as a consequence, stroke deaths may be overestimated by official routine statistics for the Chinese population. Similar discrepancies between official mortality statistics and WHO MONICA stroke register data seem to be present for populations in the Russian Federation and the former Yugoslavia. In one country, the former East Germany, the contrary was observed; routine statistics underestimated the true number of stroke deaths. Among most MONICA populations, however, there was very good agreement between mortality rates by official statistics versus the stroke registers. Thus, official mortality statistics may be used for comparisons of international populations in which validation has been undertaken.
The case-fatality rate at 28 days varied markedly (threefold) between populations. Whether this variation is due to differences in case ascertainment, stroke severity, or the result of different management of acute stroke cannot be answered by the present data. The relative frequency of stroke subtypes will influence the overall case-fatality rates, since cerebral hemorrhage is fatal more often than is ischemic brain infarction.12 However, the present data do not permit analyses of stroke subtypes. Future analyses of more recent MONICA Project stroke data and from selected populations may help clarify this issue. Such analyses may also help clarify whether differences in medical services available to men versus women contribute to the consistently higher case-fatality rate among women in the MONICA populations.
The stroke component of the WHO MONICA project was optional, and only half of all MCCs established registers to monitor stroke events in addition to coronary events. Thus, the present study covers mainly European populations of middle-aged subjects. Despite these limitations, the WHO MONICA Project provides a unique opportunity to perform cross-sectional and longitudinal comparisons of stroke epidemiology among many populations, and, once completed, the study will have compiled data on what is probably the most stroke events ascertained in a comparable manner in recent years.
|
Acknowledgments |
|---|
The authors are indebted to Dr Ruth Bonita for reviewing the manuscript.
Sites and Key Personnel of Contributing MONICA Centers
China. Beijing Heart, Lung, and Blood Vessel Research
Institute: Wu Zhaosu (Principal Investigator) and Wu Yingkai (Former
Principal Investigator).
Denmark. Glostrup Population Studies, Glostrup University Hospital: M. Schroll (Principal Investigator), H. Kirkby, S. Henriksen, D. Jeppesen, G. Vincents, and P. Thorvaldsen.
Finland. National Public Health Institute, Helsinki: E. Kaarsalo, E.V. Narva, T. Nuottimäki, P. Puska (Former Principal Investigator), K. Salmi, V. Salomaa, C. Sarti, J. Sivenius, J. Torppa, and J. Tuomilehto (Principal Investigator).
Germany. Department of Clinical and Social Medicine, University Medical Clinic, Heidelberg: E. Nüssel (Principal Investigator) and E. Ostör-Lamm (Co-Principal Investigator); Centre for Epidemiology and Health Research, Berlin: W. Barth (Principal Investigator), L. Heinemann (Principal Investigator), and D. Eisenblätter.
Italy. Institute of Cardiology, Regional Hospital, Udine: G.A. Feruglio (Principal Investigator).
Lithuania. Institute of Cardiology, Kaunas Medical Academy: J. Bluzhas (Principal Investigator).
Poland. Department of Cardiovascular Epidemiology and Prevention, National Institute of Cardiology, Warsaw: S.L. Ryvik (Principal Investigator), M. Polakowska (Co-Principal Investigator), G. Broda (Co-Principal Investigator), B. Jasinski (Responsible Officer).
Russian Federation. National Research Centre for Preventive Medicine, Moscow: T. Varlamova (Principal Investigator); Institute of Internal Medicine, Academy of Medical Sciences, Novosibirsk: Y. Nikitin (Principal Investigator) and V. Feigin.
Sweden. Östra Hospital Preventive Cardiology Unit, Göteborg: L. Wilhelmsen (Principal Investigator); Department of Internal Medicine, Kalix Lasarett, Kalix: F. Huhtasaari (Principal Investigator) and V. Lundberg; Department of Medicine, Umeå University Hospital: P.O. Wester (Principal Investigator), K. Asplund, and B. Stegmayr.
Yugoslavia. Novi Sad Health Centre: M. Planojevic (Principal Investigator) and D. Jacovljevic (Former Principal Investigator).
MONICA Management Center World Health Organization, Geneva, Switzerland. I. Gyarfas (Responsible Officer), Z. Pisa (Former Responsible Officer), S.R.A. Dodu (Former Responsible Officer), S. Böthig, I. Martin, M.J. Watson, and M. Hill.
MONICA Stroke Advisory Group. K. Asplund, R. Bonita, D. Eisenblätter, S. Hatano, M. Schroll, P.O. Wester, Wu Zhaosu, H. Tunstall-Pedoe, and J. Tuomilehto.
MONICA Data Center. National Public Health Institute, Helsinki, Finland: K. Kuulasmaa (Responsible Officer), J. Tuomilehto (Former Responsible Officer), V. Moltchanov, A.-M. Rajakangas, E. Ruokokoski, V. Molchanov, and J. Torppa.
MONICA Quality Control Center for Event Registration. University of Dundee, Scotland: H. Tunstall-Pedoe (Responsible Officer), K. Barret, and C. Brown.
MONICA Steering Committee. S. Sans (Chair), A. Evans (Chair, Publications Subcommittee), M. Hobbs, H. Tunstall-Pedoe (Rapporteur), I. Gyarfas, K. Kuulasmaa, and A. Shatchkute; Consultants: A. Dobson, Z. Pisa, O.D. Williams; previous Steering Committee: F. Gutzwiller, S.P. Fortmann, A. Menotti, P. Puska, S.L. Rywik, U. Keil, R. Beaglehole, and former Chiefs of CVD WHO (Geneva, Switzerland) V. Zaitsev (WHO, Copenhagen) and J. Tuomilehto; and former Consultants: M.J. Karvonen (Helsinki, Finland), R.J. Prineas (Minneapolis, Minn), M. Feinleib (Bethesda, Md), and F.H. Epstein (Zürich, Switzerland).
Received July 28, 1994; revision received November 21, 1994; accepted December 16, 1994.
|
References |
|---|
|
TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
1. Tunstall-Pedoe H, for the WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (Monitoring Trends and Determinants in Cardiovascular Disease): a major international collaboration. J Clin Epidemiol. 1988;41: 105-114.
2. Böthig S, for the WHO MONICA Project. WHO MONICA Project: objectives and design. Int J Epidemiol. 1989;18(suppl 1):29-37.
3. Uemura K, Pisa Z. Recent trends in cardiovascular disease mortality in 27 industrialized countries. World Health Stat Q. 1985;38:142-156. [Medline] [Order article via Infotrieve]
4. Uemura K, Pisa Z. Trends in cardiovascular disease mortality in industrialized countries since 1950. World Health Stat Q. 1988;41:155-168. [Medline] [Order article via Infotrieve]
5.
Bonita R, Stewart A, Beaglehole R. International trends in
stroke mortality: 1970-1985. Stroke. 1990;21:989-992.
6. Tuomilehto J, Kuulasmaa K, Torppa J, for the World Health Organization MONICA Project. Geographic variation in mortality from cardiovascular diseases: WHO MONICA Project Principal Investigators. World Health Stat Q. 1987;40:171-184. [Medline] [Order article via Infotrieve]
7. Thom JT. Stroke mortality trends: an international perspective. Ann Epidemiol. 1993;3:509-518. [Medline] [Order article via Infotrieve]
8. Bonita R. Epidemiology of stroke. Lancet. 1992;339:342-344. [Medline] [Order article via Infotrieve]
9. Malmgren R, Warlow C, Bamford J, Sandercock P. Geographical and secular trends in stroke incidence. Lancet. 1987;1:1196-1200.
10. Alter M, Zhang ZX, Sobel E, Fisher M, Davanipour Z, Friday G. Standardized incidence ratios of stroke: a worldwide review. Neuroepidemiology. 1986;5:148-158. [Medline] [Order article via Infotrieve]
11. Broderick JP. Stroke trends in Rochester, Minnesota, during 1945 to 1984. Ann Epidemiol. 1993;3:476-479. [Medline] [Order article via Infotrieve]
12.
Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. A
prospective study of acute cerebrovascular disease in the community:
the Oxfordshire Community Stroke Project 1981-1986. J Neurol
Neurosurg Psychiatry. 1990;53:16-22.
13.
McGovern PG, Burke GL, Sprafka JM, Xue S, Folsom AR, Blackburn
H. Trends in mortality, morbidity and risk factor levels for stroke
from 1960-1990: the Minnesota Heart Survey 1992. JAMA. 1992;268:753-759.
14.
d'Allesandro G, Giovanni M, Roveyaz L, Iannizi L,
Compagnoni
MP, Blanc S, Bottacchi E. Incidence and prognosis of stroke in Valle
d'Aosta, Italy: first-year results of a community-based study.
Stroke. 1992;23:1712-1715.
15.
Chang CC, Chen CJ. Secular trend of mortality from cerebral
infarction and cerebral hemorrhage in Taiwan, 1974-1988.
Stroke. 1993;24:212-218.
16.
Wolf PA, D'Agostino RB, O'Neal MA, Sytkowski P, Kase
CS,
Belanger AJ, Kannel WB. Secular trends in stroke incidence and
mortality: the Framingham Study. Stroke. 1992;23:1551-1555.
17.
Lindenstrøm E, Boysen G, Nyboe J, Appelyard M. Stroke
incidence in Copenhagen, 1976-1988. Stroke. 1992;23:28-32.
18. Aho K, Harmsen P, Hatano S, Marquardsen J, Smirnov VE, Strasser T. Cerebrovascular diseases in the community: results of a WHO collaborative study. Bull World Health Org. 1980;58:113-130. [Medline] [Order article via Infotrieve]
19. Stegmayr B, Asplund K, Wester PO. Trends in incidence, case-fatality rate, and severity of stroke in Northern Sweden, 1985-1991. Stroke. 1994;25:1738-1745. [Abstract]
20. Tuomilehto J, Sarti C, Narva EV, Salmi K, Sivenius J, Kaarsalo E, Salomaa V, Torppa J. The FIN-MONICA Stroke Register: community based stroke registration and analysis of stroke incidence in Finland, 1983-1985. Am J Epidemiol. 1992;135(11):1259-1270.
21.
Harmsen P, Tsipogianni A, Wilhelmsen L. Stroke incidence rates
were unchanged, while fatality rates declined, during 1971-1987 in
Göteborg, Sweden. Stroke. 1992;23:1410-1415.
22. Bonita R, Broad JB, Beaglehole R. Changes in stroke incidence and case-fatality in Auckland, New Zealand between 1981 and 1991. Lancet. 1993;342:1470-1473. [Medline] [Order article via Infotrieve]
23. Anderson CS, Jamrozic KD, Burvill PW, Chakera TMH, Johnson GA, Stewart-Wynne EG. Ascertaining the true incidence of stroke: experience from the Perth Community Stroke Study, 1989-1990. Med J Aust. 1993;158:80-84. [Medline] [Order article via Infotrieve]
24. Hong Y, Bots ML, Pan X, Hofman A, Grobbee DE, Chen H. Stroke incidence and mortality in rural and urban Shanghai from 1984 through 1991: findings from a community-based registry. Stroke. 1994;25:1165-1169. [Abstract]
25. Sandercock P, Molyneaux A, Warlow C. Value of computerized tomography in patients with stroke: the Oxfordshire Community Stroke Project. Br Med J. 1985;290:193-197.
26. Cancer incidence in five continents. In: Waterhouse J, Muir C, Correo P, Powell J, eds. Vol II, IARC Scientific Publications No 15. Lyons, France: International Agency for Research on Cancer; 1976.
27. Dobson AJ, Kuulasmaa K, Eberle E, Scherer J. Confidence intervals for weighted sums of Poisson parameters. Stat Med. 1991;10:457-462. [Medline] [Order article via Infotrieve]
28. Asplund K, Tuomilehto J, Stegmayr B, Wester PO, Tunstall-Pedoe H. Diagnostic criteria and quality control of the registration of stroke events in the MONICA project. Acta Med Scand. 1988;728(suppl):26-39.
29.
Asplund K, Bonita R, Kuulasmaa K, Rajakangas A-M, Feigin V,
Schaedlich H, Suzuki K, Thorvaldsen P, Tuomilehto J, for the WHO MONICA
Project. Multinational comparisons of stroke epidemiology: evaluation
of case ascertainment in the WHO MONICA Stroke Study.
Stroke. 1995;26:355-360.
30.
Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D,
Rajakangas A-M, Pajak A, for the WHO MONICA Project. Myocardial
infarction and coronary deaths in the World Health Organizations MONICA
Project: registration procedures, event rates and case fatality rates
in 38 populations from 21 countries in 4 continents.
Circulation. 1994;90:583-612.
This article has been cited by other articles:
 |
|
 |
|
  Z. X. Zhang, B. L. Plassman, Q. Xu, G.E.P. Zahner, B. Wu, M. Y. Gai, H. B. Wen, X. Chen, S. Gao, D. Hu, et al. Lifespan influences on mid- to late-life cognitive function in a Chinese birth cohort Neurology, July 21, 2009; 73(3): 186 - 194. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Saarela, S. Kulathinal, and J. Karvanen Joint analysis of prevalence and incidence data using conditional likelihood Biostat., July 1, 2009; 10(3): 575 - 587. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Liang, A. H. Lee, C. W. Binns, R. Huang, D. Hu, and Q. Zhou Tea Consumption and Ischemic Stroke Risk: A Case-Control Study in Southern China Stroke, July 1, 2009; 40(7): 2480 - 2485. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Petrea, A. S. Beiser, S. Seshadri, M. Kelly-Hayes, C. S. Kase, and P. A. Wolf Gender Differences in Stroke Incidence and Poststroke Disability in the Framingham Heart Study Stroke, April 1, 2009; 40(4): 1032 - 1037. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ali, S. Atula, P. M.W. Bath, J. Grotta, W. Hacke, P. Lyden, J. R. Marler, R. L. Sacco, K. R. Lees, and for the VISTA Investigators Stroke Outcome in Clinical Trial Patients Deriving From Different Countries Stroke, January 1, 2009; 40(1): 35 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ueshima, A. Sekikawa, K. Miura, T. C. Turin, N. Takashima, Y. Kita, M. Watanabe, A. Kadota, N. Okuda, T. Kadowaki, et al. Cardiovascular Disease and Risk Factors in Asia: A Selected Review Circulation, December 16, 2008; 118(25): 2702 - 2709. [Full Text] [PDF]
|
|
|
|
|
|
C. E.P. van Munster, M. von und zu Fraunberg, G. J.E. Rinkel, J. Rinne, T. Koivisto, and A. Ronkainen Differences in Aneurysm and Patient Characteristics Between Cohorts of Finnish and Dutch Patients With Subarachnoid Hemorrhage: Time Trends Between 1986 and 2005 Stroke, December 1, 2008; 39(12): 3166 - 3171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fatema, K. R. Bailey, G. W. Petty, I. Meissner, M. Osranek, A. A. Alsaileek, B. K. Khandheria, T. S. Tsang, and J. B. Seward Increased Left Atrial Volume Index: Potent Biomarker for First-Ever Ischemic Stroke Mayo Clin. Proc., October 1, 2008; 83(10): 1107 - 1114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Umesawa, H. Iso, C. Date, A. Yamamoto, H. Toyoshima, Y. Watanabe, S. Kikuchi, A. Koizumi, T. Kondo, Y. Inaba, et al. Relations between dietary sodium and potassium intakes and mortality from cardiovascular disease: the Japan Collaborative Cohort Study for Evaluation of Cancer Risks Am. J. Clinical Nutrition, July 1, 2008; 88(1): 195 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Sun, M. Bello-Roufai, and X. Wang RNAi inhibition of mineralocorticoid receptors prevents the development of cold-induced hypertension Am J Physiol Heart Circ Physiol, April 1, 2008; 294(4): H1880 - H1887. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Gibson, L. J. Gray, P. M. W. Bath, and S. P. Murphy Progesterone for the treatment of experimental brain injury; a systematic review Brain, February 1, 2008; 131(2): 318 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Stevens, S. Payne, C. Burton, J. Addington-Hall, and A. Jones Palliative care in stroke: a critical review of the literature Palliative Medicine, June 1, 2007; 21(4): 323 - 331. [Abstract] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]
|
|
|
|
 |
|
 M.-J. Tsai, W.-C. Lin, C.-H. Kuo, H.-F. Chou, and R.-C. Yang Acute Midbrain Infarction in a Child With Intracranial Carotid Artery Hypoplasia and Aberrant Cerebral Vasculature: A Case Report J Child Neurol, April 1, 2007; 22(4): 465 - 470. [Abstract] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. Van den Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J., January 1, 2007; 28(1): 88 - 136. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Carandang, S. Seshadri, A. Beiser, M. Kelly-Hayes, C. S. Kase, W. B. Kannel, and P. A. Wolf Trends in Incidence, Lifetime Risk, Severity, and 30-Day Mortality of Stroke Over the Past 50 Years JAMA, December 27, 2006; 296(24): 2939 - 2946. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Koren-Morag, U. Goldbourt, and D. Tanne Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease. Neurology, July 25, 2006; 67(2): 224 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Benatru, O. Rouaud, J. Durier, F. Contegal, G. Couvreur, Y. Bejot, G. V. Osseby, D. Ben Salem, F. Ricolfi, T. Moreau, et al. Stable Stroke Incidence Rates but Improved Case-Fatality in Dijon, France, From 1985 to 2004 Stroke, July 1, 2006; 37(7): 1674 - 1679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Mandelzweig, U. Goldbourt, V. Boyko, and D. Tanne Perceptual, Social, and Behavioral Factors Associated With Delays in Seeking Medical Care in Patients With Symptoms of Acute Stroke Stroke, May 1, 2006; 37(5): 1248 - 1253. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L J Gray, N Sprigg, P M W Bath, P Sorensen, E Lindenstrom, G Boysen, P P De Deyn, P Friis, D Leys, R Marttila, et al. Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: data from the tinzaparin in acute ischaemic stroke trial (TAIST) J. Neurol. Neurosurg. Psychiatry, March 1, 2006; 77(3): 327 - 333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X.-H. Fang, X.-H. Zhang, Q.-D. Yang, X.-Y. Dai, F.-Z. Su, M.-L. Rao, S.-P. Wu, X.-L. Du, W.-Z. Wang, and S.-C. Li Subtype Hypertension and Risk of Stroke in Middle-Aged and Older Chinese: A 10-Year Follow-Up Study Stroke, January 1, 2006; 37(1): 38 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Wang, R. Cade, and Z. Sun Human eNOS gene delivery attenuates cold-induced elevation of blood pressure in rats Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H1161 - H1168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N.J.A. van Exel, M.A. Koopmanschap, W. Scholte op Reimer, L.W. Niessen, and R. Huijsman Cost-effectiveness of integrated stroke services QJM, June 1, 2005; 98(6): 415 - 425. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.A. Ogun, F.I. Ojini, B. Ogungbo, K.O. Kolapo, and M.A. Danesi Stroke in South West Nigeria: A 10-Year Review Stroke, June 1, 2005; 36(6): 1120 - 1122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Spolaore, S. Brocco, U. Fedeli, C. Visentin, E. Schievano, F. Avossa, G. Milan, V. Toso, D. Vanuzzo, L. Pilotto, et al. Measuring Accuracy of Discharge Diagnoses for a Region-Wide Surveillance of Hospitalized Strokes Stroke, May 1, 2005; 36(5): 1031 - 1034. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Pajunen, R. Paakkonen, H. Hamalainen, I. Keskimaki, T. Laatikainen, M. Niemi, H. Rintanen, and V. Salomaa Trends in Fatal and Nonfatal Strokes Among Persons Aged 35 to >=85 Years During 1991-2002 in Finland Stroke, February 1, 2005; 36(2): 244 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Sun, X. Wang, C. E. Wood, and J. R. Cade Genetic AT1A receptor deficiency attenuates cold-induced hypertension Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2005; 288(2): R433 - R439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Simpkins, S.-H. Yang, R. Liu, E. Perez, Z. Y. Cai, D. F. Covey, and P. S. Green Estrogen-Like Compounds for Ischemic Neuroprotection Stroke, November 1, 2004; 35(11_suppl_1): 2648 - 2651. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Medin, A. Nordlund, and K. Ekberg Increasing Stroke Incidence in Sweden Between 1989 and 2000 Among Persons Aged 30 to 65 Years: Evidence From the Swedish Hospital Discharge Register Stroke, May 1, 2004; 35(5): 1047 - 1051. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Sivenius, J. Tuomilehto, P. Immonen-Raiha, M. Kaarisalo, C. Sarti, J. Torppa, K. Kuulasmaa, M. Mahonen, A. Lehtonen, and V. Salomaa Continuous 15-Year Decrease in Incidence and Mortality of Stroke in Finland: The FINSTROKE Study Stroke, February 1, 2004; 35(2): 420 - 425. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Stevens, R. L. Coleman, A. I. Adler, I. M. Stratton, D. R. Matthews, and R. R. Holman Risk Factors for Myocardial Infarction Case Fatality and Stroke Case Fatality in Type 2 Diabetes: UKPDS 66 Diabetes Care, January 1, 2004; 27(1): 201 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.R. Elter, S. Offenbacher, J.F. Toole, and J.D. Beck Relationship of Periodontal Disease and Edentulism to Stroke/TIA Journal of Dental Research, December 1, 2003; 82(12): 998 - 1001. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Stegmayr and K. Asplund Stroke in Northern Sweden Scand J Public Health, November 1, 2003; 31(61_suppl): 60 - 69. [Abstract] [PDF]
|
|
|
|
|
|
Bibliography Scand J Public Health, November 1, 2003; 31(61_suppl): 85 - 91. [PDF]
|
|
|
|
 |
|
 S. E Roberts and M. J Goldacre Time trends and demography of mortality after fractured neck of femur in an English population, 1968-98: database study BMJ, October 4, 2003; 327(7418): 771 - 775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Okamoto Editorial Comment--Stroke Incidence and Quality Standard for Comparison Stroke, September 1, 2003; 34(9): 2107 - 2108. [Full Text] [PDF]
|
|
|
|
|
|
C. Sarti, B. Stegmayr, H. Tolonen, M. Mahonen, J. Tuomilehto, and K. Asplund Are Changes in Mortality From Stroke Caused by Changes in Stroke Event Rates or Case Fatality?: Results From the WHO MONICA Project Stroke, August 1, 2003; 34(8): 1833 - 1840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fogelholm Editorial Comment--Explanations for International Trends in Stroke Mortality Stroke, August 1, 2003; 34(8): 1840 - 1841. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Y. Liu, A. K. Death, and D. J. Handelsman Androgens and Cardiovascular Disease Endocr. Rev., June 1, 2003; 24(3): 313 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Wolf-Maier, R. S. Cooper, J. R. Banegas, S. Giampaoli, H.-W. Hense, M. Joffres, M. Kastarinen, N. Poulter, P. Primatesta, F. Rodriguez-Artalejo, et al. Hypertension Prevalence and Blood Pressure Levels in 6 European Countries, Canada, and the United States JAMA, May 14, 2003; 289(18): 2363 - 2369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Di Carlo, M. Lamassa, M. Baldereschi, G. Pracucci, A. M. Basile, C. D.A. Wolfe, M. Giroud, A. Rudd, A. Ghetti, and D. Inzitari Sex Differences in the Clinical Presentation, Resource Use, and 3-Month Outcome of Acute Stroke in Europe: Data From a Multicenter Multinational Hospital-Based Registry Stroke, May 1, 2003; 34(5): 1114 - 1119. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Sun, R. Cade, Z. Zhang, J. Alouidor, and H. Van Angiotensinogen Gene Knockout Delays and Attenuates Cold-Induced Hypertension Hypertension, February 1, 2003; 41(2): 322 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Seibert, E. Barbouche, J. Fagan, E. Myint, T. Wetterneck, and M. Wittemyer Prescribing Oral Contraceptives for Women Older Than 35 Years of Age Ann Intern Med, January 7, 2003; 138(1): 54 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Piriyawat, M. Smajsova, M. A. Smith, S. Pallegar, A. Al-Wabil, N. M. Garcia, J. M. Risser, L. A. Moye, and L. B. Morgenstern Comparison of Active and Passive Surveillance for Cerebrovascular Disease: The Brain Attack Surveillance in Corpus Christi (BASIC) Project Am. J. Epidemiol., December 1, 2002; 156(11): 1062 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tolonen, M. Mahonen, K. Asplund, D. Rastenyte, K. Kuulasmaa, D. Vanuzzo, and J. Tuomilehto Do Trends in Population Levels of Blood Pressure and Other Cardiovascular Risk Factors Explain Trends in Stroke Event Rates?: Comparisons of 15 Populations in 9 Countries Within the WHO MONICA Stroke Project Stroke, October 1, 2002; 33(10): 2367 - 2375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Liu, S.-H. Yang, E. Perez, K. D. Yi, S. S. Wu, K. Eberst, L. Prokai, K. Prokai-Tatrai, Z. Y. Cai, D. F. Covey, et al. Neuroprotective Effects of a Novel Non-Receptor-Binding Estrogen Analogue: In Vitro and In Vivo Analysis Stroke, October 1, 2002; 33(10): 2485 - 2491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Kemmeren, B. C. Tanis, M. A.A.J. van den Bosch, E. L.E.M. Bollen, F. M. Helmerhorst, Y. van der Graaf, F. R. Rosendaal, and A. Algra Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) Study: Oral Contraceptives and the Risk of Ischemic Stroke Stroke, May 1, 2002; 33(5): 1202 - 1208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C D A Wolfe, A G Rudd, R Howard, C Coshall, J Stewart, E Lawrence, C Hajat, and T Hillen Incidence and case fatality rates of stroke subtypes in a multiethnic population: the South London Stroke Register J. Neurol. Neurosurg. Psychiatry, February 1, 2002; 72(2): 211 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M L Bots, P C Elwood, Y Nikitin, J T Salonen, A Freire de Concalves, D Inzitari, J Sivenius, A Trichopoulou, J Tuomilehto, P J Koudstaal, et al. The EUROSTROKE cohorts: a short description and data analytical approach J Epidemiol Community Health, February 1, 2002; 56(90001): i2 - 7. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M L Bots, Y Nikitin, J T Salonen, P C Elwood, S Malyutina, A Freire de Concalves, J Sivenius, A Di Carlo, P Lagiou, J Tuomilehto, et al. Left ventricular hypertrophy and risk of fatal and non-fatal stroke. EUROSTROKE: a collaborative study among research centres in Europe J Epidemiol Community Health, February 1, 2002; 56(90001): i8 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M L Bots, P C Elwood, Y Nikitin, J T Salonen, A Freire de Concalves, D Inzitari, J Sivenius, V Benetou, J Tuomilehto, P J Koudstaal, et al. Total and HDL cholesterol and risk of stroke. EUROSTROKE: a collaborative study among research centres in Europe J Epidemiol Community Health, February 1, 2002; 56(90001): i19 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Maron, I. Olivotto, P. Bellone, M. R. Conte, F. Cecchi, B. P. Flygenring, S. A. Casey, T. E. Gohman, S. Bongioanni, and P. Spirito Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy J. Am. Coll. Cardiol., January 16, 2002; 39(2): 301 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Tanne, A. Shotan, U. Goldbourt, M. Haim, V. Boyko, Y. Adler, L. Mandelzweig, and S. Behar Severity of Angina Pectoris and Risk of Ischemic Stroke Stroke, January 1, 2002; 33(1): 245 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Yusuf, S. Reddy, S. Ounpuu, and S. Anand Global Burden of Cardiovascular Diseases: Part II: Variations in Cardiovascular Disease by Specific Ethnic Groups and Geographic Regions and Prevention Strategies Circulation, December 4, 2001; 104(23): 2855 - 2864. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Mihalka, V. Smolanka, B. Bulecza, S. Mulesa, and D. Bereczki A Population Study of Stroke in West Ukraine: Incidence, Stroke Services, and 30-Day Case Fatality Stroke, October 1, 2001; 32(10): 2227 - 2231. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Bronnum-Hansen, M. Davidsen, and P. Thorvaldsen Long-Term Survival and Causes of Death After Stroke Stroke, September 1, 2001; 32(9): 2131 - 2136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. U. Weir, P. A. G. Sandercock, S. C. Lewis, D. F. Signorini, and C. P. Warlow Variations Between Countries in Outcome After Stroke in the International Stroke Trial (IST) Stroke, June 1, 2001; 32(6): 1370 - 1377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. McKevitt, R. Dundas, and C. Wolfe Two Simple Questions to Assess Outcome After Stroke : A European Study Stroke, March 1, 2001; 32(3): 681 - 686. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Tilling Capture-recapture methods--useful or misleading? Int. J. Epidemiol., February 1, 2001; 30(1): 12 - 14. [Full Text] [PDF]
|
|
|
|
|
|
M. Lamassa, A. Di Carlo, G. Pracucci, A. M. Basile, G. Trefoloni, P. Vanni, S. Spolveri, M. C. Baruffi, G. Landini, A. Ghetti, et al. Characteristics, Outcome, and Care of Stroke Associated With Atrial Fibrillation in Europe : Data From a Multicenter Multinational Hospital-Based Registry (The European Community Stroke Project) Stroke, February 1, 2001; 32(2): 392 - 398. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Qureshi, M. F. K. Suri, L. R. Guterman, and L. N. Hopkins Cocaine Use and the Likelihood of Nonfatal Myocardial Infarction and Stroke : Data From the Third National Health and Nutrition Examination Survey Circulation, January 30, 2001; 103(4): 502 - 506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D.A. Wolfe, M. Giroud, P. Kolominsky-Rabas, R. Dundas, M. Lemesle, P. Heuschmann, and A. Rudd Variations in Stroke Incidence and Survival in 3 Areas of Europe Stroke, September 1, 2000; 31(9): 2074 - 2079. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Yepes, M. Sandkvist, M. K. K. Wong, T. A. Coleman, E. Smith, S. L. Cohan, and D. A. Lawrence Neuroserpin reduces cerebral infarct volume and protects neurons from ischemia-induced apoptosis Blood, July 15, 2000; 96(2): 569 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ingall, K. Asplund, M. Mahonen, and R. Bonita A Multinational Comparison of Subarachnoid Hemorrhage Epidemiology in the WHO MONICA Stroke Study Stroke, May 1, 2000; 31(5): 1054 - 1061. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Stegmayr, T. Vinogradova, S. Malyutina, M. Peltonen, Y. Nikitin, and K. Asplund Widening Gap of Stroke Between East and West : Eight-Year Trends in Occurrence and Risk Factors in Russia and Sweden Stroke, January 1, 2000; 31(1): 2 - 8. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Thorvaldsen, M. Davidsen, H. Bronnum-Hansen, and M. Schroll Stable Stroke Occurrence Despite Incidence Reduction in an Aging Population : Stroke Trends in the Danish Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Population Stroke, December 1, 1999; 30(12): 2529 - 2534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Di Carlo, M. Lamassa, G. Pracucci, A. M. Basile, G. Trefoloni, P. Vanni, C. D. A. Wolfe, K. Tilling, S. Ebrahim, and D. Inzitari Stroke in the Very Old : Clinical Presentation and Determinants of 3-Month Functional Outcome: A European Perspective Stroke, November 1, 1999; 30(11): 2313 - 2319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Jamrozik, R. J. Broadhurst, N. Lai, G. J. Hankey, P. W. Burvill, and C. S. Anderson Trends in the Incidence, Severity, and Short-Term Outcome of Stroke in Perth, Western Australia Stroke, October 1, 1999; 30(10): 2105 - 2111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A Stewart, R Dundas, R S Howard, A G Rudd, and C D A Wolfe Ethnic differences in incidence of stroke: prospective study with stroke register BMJ, April 10, 1999; 318(7189): 967 - 971. [Abstract] [Full Text]
|
|
|
|
|
|
C. D. A. Wolfe, K. Tilling, R. Beech, and A. G. Rudd Variations in Case Fatality and Dependency From Stroke in Western and Central Europe Stroke, February 1, 1999; 30(2): 350 - 356. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. N. Vemmos, M. L. Bots, P. K. Tsibouris, V. P. Zis, D. E. Grobbee, G. S. Stranjalis, and S. Stamatelopoulos Stroke Incidence and Case Fatality in Southern Greece : The Arcadia Stroke Registry Stroke, February 1, 1999; 30(2): 363 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Qureshi, W. H. Giles, and J. B. Croft Impaired Glucose Tolerance and the Likelihood of Nonfatal Stroke and Myocardial Infarction : The Third National Health and Nutrition Examination Survey Stroke, July 1, 1998; 29(7): 1329 - 1332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Peltonen, B. Stegmayr, and K. Asplund Time Trends in Long-term Survival After Stroke : The Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Study, 1985–1994 Stroke, July 1, 1998; 29(7): 1358 - 1365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Immonen-Raiha, M. Mahonen, J. Tuomilehto, V. Salomaa, E. Kaarsalo, E. V. Narva, K. Salmi, C. Sarti, J. Sivenius, K. Alhainen, et al. Trends in Case-Fatality of Stroke in Finland During 1983 to 1992 Stroke, December 1, 1997; 28(12): 2493 - 2499. [Abstract] [Full Text]
|
|
|
|
|
|
A. Carolei, C. Marini, M. Di Napoli, G. Di Gianfilippo, P. Santalucia, M. Baldassarre, M. Giorgio De Matteis, and F. di Orio High Stroke Incidence in the Prospective Community-Based L'Aquila Registry (1994–1998) : First Year's Results Stroke, December 1, 1997; 28(12): 2500 - 2506. [Abstract] [Full Text]
|
|
|
|
|
|
R. X. You, J. J. McNeil, H. M. O'Malley, S. M. Davis, A. G. Thrift, and G. A. Donnan Risk Factors for Stroke Due to Cerebral Infarction in Young Adults Stroke, October 1, 1997; 28(10): 1913 - 1918. [Abstract] [Full Text]
|
|
|
|
|
|
Stroke Incidence and Mortality Correlated to Stroke Risk Factors in the WHO MONICA Project : An Ecological Study of 18 Populations Stroke, July 1, 1997; 28(7): 1367 - 1374. [Abstract] [Full Text]
|
|
|
|
|
|
C. J. Currie, C. L. Morgan, L. Gill, N. C. H. Stott, and J. R. Peters Epidemiology and Costs of Acute Hospital Care for Cerebrovascular Disease in Diabetic and Nondiabetic Populations Stroke, June 1, 1997; 28(6): 1142 - 1146. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. B. Wyller, K. M. Sodring, U. Sveen, A. E. Ljunggren, and E. Bautz-Holter Are there gender differences in functional outcome after stroke? Clinical Rehabilitation, May 1, 1997; 11(2): 171 - 179. [Abstract] [PDF]
|
|
|
|
|
|
D. Ryglewicz, M. Polakowska, W. Lechowicz, G. Broda, M. Roszkiewicz, B. Jasinski, and D. B. Hier Stroke Mortality Rates in Poland Did Not Decline Between 1984 and 1992 Stroke, April 1, 1997; 28(4): 752 - 757. [Abstract] [Full Text]
|
|
|
|
|
|
C.L.M. Sudlow and C.P. Warlow Comparable Studies of the Incidence of Stroke and its Pathological Types : Results From an International Collaboration Stroke, March 1, 1997; 28(3): 491 - 499. [Abstract] [Full Text]
|
|
|
|
|
|
P. Thorvaldsen, K. Kuulasmaa, A.-M. Rajakangas, D. Rastenyte, C. Sarti, and L. Wilhelmsen Stroke Trends in the WHO MONICA Project Stroke, March 1, 1997; 28(3): 500 - 506. [Abstract] [Full Text]
|
|
|
|
|
|
D. B. Petitti, S. Sidney, C. P. Quesenberry, and A. Bernstein Incidence of Stroke and Myocardial Infarction in Women of Reproductive Age Stroke, February 1, 1997; 28(2): 280 - 283. [Abstract] [Full Text]
|
|
|
|
|
|
N. M. Bornstein, B. D. Aronovich, V. G. Karepov, A. Y. Gur, T. A. Treves, M. Oved, and A. D. Korczyn The Tel Aviv Stroke Registry: 3600 Consecutive Patients Stroke, October 1, 1996; 27(10): 1770 - 1773. [Abstract] [Full Text]
|
|
|
|
|
|
D. Jakovljevic, V. Salomaa, J. Sivenius, M. Tamminen, C. Sarti, K. Salmi, E. Kaarsalo, V. Narva, P. Immonen-Raiha, J. Torppa, et al. Seasonal Variation in the Occurrence of Stroke in a Finnish Adult Population: The FINMONICA Stroke Register Stroke, October 1, 1996; 27(10): 1774 - 1779. [Abstract] [Full Text]
|
|
|
|
|
|
J. Tuomilehto, D. Rastenyte, J. Sivenius, C. Sarti, P. Immonen-Raiha, E. Kaarsalo, K. Kuulasmaa, E. V. Narva, V. Salomaa, K. Salmi, et al. Ten-Year Trends in Stroke Incidence and Mortality in the FINMONICA Stroke Study Stroke, May 1, 1996; 27(5): 825 - 832. [Abstract] [Full Text]
|
|
|
|
|
|
N. Rozenthul-Sorokin, R. Ronen, A. Tamir, H. Geva, and R. Eldar Stroke in the Young in Israel : Incidence and Outcomes Stroke, May 1, 1996; 27(5): 838 - 841. [Abstract] [Full Text]
|
|
|
|
|
|
F.H.H. Linn, G.J.E. Rinkel, A. Algra, and J. van Gijn Incidence of Subarachnoid Hemorrhage : Role of Region, Year, and Rate of Computed Tomography: A Meta-Analysis Stroke, April 1, 1996; 27(4): 625 - 629. [Abstract] [Full Text]
|
|
|
|
|
|
R. Bonita and R. Beaglehole The Enigma of the Decline in Stroke Deaths in the United States : The Search for an Explanation Stroke, March 1, 1996; 27(3): 370 - 372. [Full Text]
|
|
|
|
|
|
C.L.M. Sudlow and C.P. Warlow Comparing Stroke Incidence Worldwide : What Makes Studies Comparable? Stroke, March 1, 1996; 27(3): 550 - 558. [Abstract] [Full Text]
|
|
|
|
|
|
R. Bonita and R. Beaglehole Monitoring Stroke : An International Challenge Stroke, April 1, 1995; 26(4): 541 - 542. [Full Text]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||