+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Trends in validated cases of fatal and nonfatal stroke, stroke classification, and risk factors in southeastern New England, 1980 to 1991 : data from the Pawtucket Heart Health Program

Trends in validated cases of fatal and nonfatal stroke, stroke classification, and risk factors in southeastern New England, 1980 to 1991 : data from the Pawtucket Heart Health Program

Stroke 31(4): 875-881

Recent US data suggest there is a slowing of the decline in stroke mortality rates, accompanied by a constant morbidity rate. Hospital discharge rates for patients with stroke are influenced by numerous factors, and community-based surveillance data for validated cases are rare. Thus, reasons for the observed trends remain unclear. In the present study, we examined trends in validated cases of stroke for 1980 to 1991 in the combined populations of the Pawtucket Heart Health Program study communities and examined concomitant trends in classification, use of diagnostic procedures, and levels of risk factors. Discharges for residents aged 35 to 74 years with International Classification of Diseases, Ninth Revision codes 431, 432, and 434 to 437 were identified through retrospective surveillance. A physician reviewed the medical records to validate case status. Between 1980 and 1991, 2269 discharges were confirmed as representing definite or probable strokes (59.5% of 3811 cases reviewed). The fatal stroke rate declined (P<0.005) and the nonfatal stroke rate remained constant in both sexes. Case-fatality rates declined significantly (P=0.003), and among strokes, the relative odds of death in 1990 versus 1980 was 0.50 (95% CI 0.34 to 0.72). The proportion of stroke discharges in which the patient received a CT scan or MRI increased 120%, and fewer strokes were classified as ill defined. Hypertension prevalence, treatment, and control rates remained constant in these populations. Although causes for the observed trends remain unclear, results suggest that the decline in mortality rates is due to improved survival rates for patients with stroke. However, constant morbidity rates combined with constant rates of hypertension highlight the need for improved prevention to reduce the impact of stroke.

(PDF emailed within 1 workday: $29.90)

Accession: 047841414

Download citation: RISBibTeXText

PMID: 10753991

Related references

Sex-specific in validated coronary heart disease in southwestern New England, 1980-1991 Data from the Pawtucket Heart Health Program. Circulation 99(8): 1104, March 2, 1999

Trends in classification of strokes and in validated discharge rates by sex, southeastern New England, 1980-1991. Circulation 99(8): 1119, March 2, 1999

Sex-specific trends in validated coronary heart disease rates in southeastern New England, 1980-1991. American Journal of Epidemiology 151(4): 417-429, 2000

Comparison of risk factors for fatal stroke and ischemic heart disease: a prospective follow up of the health survey for England. Atherosclerosis 219(2): 807-810, 2012

Stroke risk factors and 1-year mortality of stroke: Comparison of data from two population-based studies conducted in 1991/1992 and 2005. 2007

The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk. American Journal of Public Health 85(6): 777-785, 1995

Trends in risk factors, stroke subtypes and outcome. Nineteen-year data from the Sagrat Cor Hospital of Barcelona stroke registry. Cerebrovascular Diseases 26(5): 509-516, 2008

Risk score for in-hospital ischemic stroke mortality derived and validated within the Get With the Guidelines-Stroke Program. Circulation 122(15): 1496-1504, 2010

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. World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease. Stroke 33(10): 2367-2375, 2002

Trends in coronary heart disease and stroke mortality The Brazilian heart and stroke surveys, 1980 through 1998. Circulation 106(19 Supplement): II 725, November 5, 2002

Secular trends in cardiovascular disease risk factors the minnesota heart health program 1980 1988. American Journal of Epidemiology 132(4): 765, 1990

Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis. Journal of Clinical Endocrinology and Metabolism 100(6): 2181-2191, 2015

Sleep duration and risk of fatal and nonfatal stroke: a prospective study and meta-analysis. Neurology 84(11): 1072-1079, 2015

The cog-4 subset of the national institutes of health stroke scale as a measure of cognition: relationship with baseline factors and functional outcome after stroke using data from the virtual international stroke trials archive. Stroke Research and Treatment 2013: 562506-562506, 2013

Secular trends in ischemic stroke subtypes and stroke risk factors. Stroke 45(11): 3208-3213, 2015