Stroke mortality rates have recently plateaued or increased in Europe after overall declines for the past 35 years, according to a study published in the European Heart Journal.
“Our findings highlight a need to counter inequalities by understanding local contexts in disease occurrence and treatment,” Nick Townsend, BSc(Hons), MSc, PhD, associate professor in public health epidemiology at the University of Bath in the United Kingdom, said in a press release. “In particular, we need to encourage the implementation of evidence-based recommendations in the prevention and treatment of stroke in all countries. Many countries have been able to reduce the mortality burden from stroke in recent years. We must understand why this is not happening in all countries and identify barriers to the implementation of evidence based recommended practice in countries that are slow to adopt them.”
Rushabh Shah, of the Centre on Population Approaches for Non-Communicable Disease Prevention at University of Oxford in the United Kingdom, and colleagues analyzed data from the WHO global mortality database of participants from Europe between 1980 and 2016. Data included mortality rates from all cerebrovascular diseases and three subtypes: hemorrhagic stroke, ischemic stroke and subarachnoid hemorrhage.
Between 1980 and 2016, there were significant decreases in age-standardized mortality rates related to cerebrovascular disease in 34 countries for men (67%) and 34 countries for women (67%). The most significant decreases were seen in Western Europe for men and women (96% and 91%, respectively).
The median average annual percentage change in all countries was –2.7% for both men and women, with the most negative in Western Europe (–3.6% for both men and women) and least negative in Central Asia for women (–0.9%) and Eastern Europe for men (–0.7%).
The most recent evidence found that there was a recent plateau in stroke mortality in 14% of countries for men and in 12% of countries for women. Recent increases were also seen in 6% of countries for men and in 4% of countries for women.
Increases in mortality rates were greater for ischemic stroke, which was seen in 18% of countries for women and in 16% of countries for men. Increases in hemorrhagic stroke mortality were seen in 2% of countries for women and 6% of countries for men.
“These findings highlight the need for continued research into the inequalities in both the stroke mortality outcomes and recent trends across Europe, as well as the causes behind any recent plateauing of total cerebrovascular disease or its subtypes,” Shah and colleagues wrote. “Continued monitoring of trends in cerebrovascular disease and subtype mortality, incidence, case-fatality, and risk factors across the region is paramount to ensure interventions are well-targeted and should be a priority for future research.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.