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Original Articles

Age- and Sex-Specific Trends in Fatal Incidence and Hospitalized Incidence of Stroke in Scotland, 1986 to 2005

James D. Lewsey, PhD; Pardeep S. Jhund, MBChB; Michelle Gillies, MBChB; Jim W.T. Chalmers, MBChB; Adam Redpath, MA; Laura Kelso, BSc; Andrew Briggs, DPhil; Matthew Walters, MD; Peter Langhorne, PhD; Simon Capewell, MD; John J.V. McMurray, MD and Kate MacIntyre, MD

From the Department of Public Health (J.D.L., P.S.J., M.G., A.B., K.M.), British Heart Foundation, Glasgow Cardiovascular Research Centre (P.S.J., J.J.V.M.), and Cardiovascular and Medical Sciences (M.W., P.L.), University of Glasgow, United Kingdom; Information Services Division (J.W.T.C., A.R., L.K.), Edinburgh, United Kingdom; and the Department of Public Health (S.C.), University of Liverpool, Liverpool, United Kingdom.

Correspondence to Kate MacIntyre, MD, Department of Public Health, University of Glasgow, Glasgow G12 8RZ, United Kingdom. E-mail k.macintyre{at}clinmed.gla.ac.uk

Received October 2, 2008; accepted May 18, 2009.

Background— Temporal trends in stroke incidence are unclear. We aimed to examine age- and sex-specific temporal trends in incidence of fatal and nonfatal hospitalized stroke in Scotland from 1986 to 2005.

Methods and Results— Mean age at the time of first stroke was 70.8 (SD, 12.9) years in men and 76.4 (12.9) years in women. Between 1986 and 2005, rates fell in men from 235 (95% CI, 229 to 242) to 149 (144 to 154) and in women from 299 (292 to 306) to 182 (177 to 188). Poisson modeling showed that temporal trends were influenced by age with declines in incidence of hospitalized stroke starting later in younger than older age groups. In both men and women aged under 55 years, the overall incidence rate of stroke was significantly higher in 2005 than in 1986.

Conclusions— We report in a whole country that the overall incidence of stroke declined steadily and substantially between 1986 and 2005, with a relative reduction in the risk of stroke of 31% in men and 42% in women. Reductions in rates of both hospitalized and nonhospitalized fatal stroke contributed to this overall decline. The increase in incident stroke rates in young people is of concern.

Key Words: stroke • epidemiology • sex

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