Trends of Stroke Incidence from 1995 to 2013 in Joinville, Brazil

Authors:
  • PCPedro T. Cougo-Pinto
    Pedro T. Cougo-Pinto
  • PMPedro S.C. Magalhaes
    Pedro S.C. Magalhaes
  • ALAlexandre L. Longo
    Alexandre L. Longo
  • CMCarla H.C. Moro
    Carla H.C. Moro
  • CAClaudio H. Amaral
    Claudio H. Amaral
  • GCGerson Costa
    Gerson Costa
  • FRFelipe I. Reis
    Felipe I. Reis
  • AGAnderson R.R. Gonçalves
    Anderson R.R. Gonçalves
  • VNVivian Nagel
    Vivian Nagel
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Abstract
Background: Temporal trends on the incidence of stroke and its subtypes could help assess on-going public health policies and point to further targets for action among middle- and low-income countries, where the stroke burden is very high. This study aimed at evaluating longitudinal trends of stroke incidence in Joinville, Brazil. Methods: We ascertained the incidence of all first-ever strokes occurred in 1995, 2005-2006 and 2012-2013, which were extracted from Joinville Stroke Registry, a prospective epidemiological data bank, launched in 1995. Results: From 1995 to 2013, the age-adjusted incidence of all strokes decreased 37% (95% CI 32-42). From 2005 to 2013, the haemorrhagic stroke (HS) incidence decreased 60% (95% CI 13-86), ischemic stroke (IS) incidence decreased 15% (95% CI 1-28), and subarachnoid haemorrhage incidence remained stable. The proportion of IS and HS patients with regularly treated hypertension increased by 60% (p = 0.01) and 33% (p = 0.01), respectively. The proportion of IS and HS patients that quit smoking increased 8% (p = 0.03) and 17% (p = 0.03), respectively. Conclusions: Stroke incidence has been decreasing in Joinville over the last 18 years, more so for HS than IS. Better control of hypertension and tobacco use might explain these findings.