(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.
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
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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 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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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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]
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R. Bonita and R. Beaglehole Monitoring Stroke : An International Challenge Stroke, April 1, 1995; 26(4): 541 - 542. [Full Text]
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