Declining incidence and mortality of stroke?

The incidence and mortality from stroke in Espoo-Kauniainen, Finland, in 1972-73 were compared to the incidence and mortality from stroke in the same area 1978-80. The factors at the acute stage influencing case fatality were also analyzed. A declining trend in age-adjusted incidence of stroke was observed, though failing to reach statistical significance. The greatest decline was seen in the incidence of cerebral hemorrhage in men, with a statistically significant difference. The incidence of subarachnoid hemorrhage also decreased, and in women the decline was significant. There was no decrease at all of the incidence of cerebral infarction. The total mortality displayed no clear declining trend. However, the mortality from cerebral hemorrhage after three months from stroke had gone down from 72% to 59%. The most important factors responsible for increased case fatality were: lowered level of consciousness, cerebral hemorrhage and old age. The case fatality was also higher for women than for men. Previous heart diseases increased the mortality, but hypertension, diabetes, pure myocardial infarction and previous transient ischaemic attacks had no influence on mortality. The cause of decline in the incidence of cerebral hemorrhage might be improved care of hypertension: the decline in the incidence of subarachnoid hemorrhage however remains unclear.