There has been a recent decline of about 20% to 40% in the incidence of cerebrovascular accidents (stroke). Although this is attributed to the improvement of risk factor control, the reason behind it is not utterly clear. This study estimated the impact of modifiable cardiovascular risk factors on the incidence of stroke between 1995 and 2012.
The risk of ischemic stroke was estimated by proportional regression among 26,329 participants in the register. The estimate was adjusted for unmodifiable risk factors such as age and gender.
There were 1226 new stroke cases per 36,7636 person-years of follow-up. Changes in risk factors accounted for 57% of the decrease in the incidence of this event from 1995 to 2012. The two factors that contributed the most to incidence decrease were systolic blood pressure (decreased by 26%) and smoking prevalence (decreased by 17%). Conversely, increasing diabetes prevalence contributed negatively to stroke incidence.
Conclusion
Changes in cardiovascular risk factors accounted for 57% of the decrease in stroke incidence. Reduction in systolic blood pressure and prevalence of smoking were the most important contributors.
Original title: Declining Incidence of Ischemic Stroke. What Is the Impact of Changing Risk Factors? The Tromso Study 1995 to 2012.
Reference: Anne M. Vangen-Lonne et al. Stroke. 2017 Feb 10. [Epub ahead of print].
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