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      Long-term trends in the prevalence of patients hospitalized with ischemic stroke from 1995 to 2010 in Sweden

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          Abstract

          Objective

          The prevalence of stroke is expected to increase partly because of prolonged life expectancy in the general population. The objective of this study was to investigate trends in the prevalence of patients hospitalized with ischemic stroke (IS) in Sweden from 1995–2010.

          Methods

          The Swedish inpatient and cause-specific death registries were used to estimate the absolute numbers and prevalence of patients who were hospitalized with and survived an IS from 1995–2010.

          Results

          The overall number of IS increased from 129,418 in 1995 to 148,778 in 2010. In 1995, the prevalence of IS was 189 patients per 10,000 population. An increase in overall prevalence was observed until 2000, and then it remained stable, followed by a decline with an annual percentage change of (APC) -0.8% (95% CI -1.0 to 0.6) and with a final prevalence of 199 patients per 10,000 population in 2010. The prevalence of IS in people aged <45 years increased from 6.4 in 1995 to 7.6 patients per 10,000 population in 2010, with an APC of 2.1% (95% CI 0.9 to 3.4) from 1995–1998 and 0.7% (95% CI 0.6–0.9) from 1998–2010. Among those aged 45–54 years, the prevalence rose through the mid to late 1990s, followed by a slight decrease (APC: -0.7%, 95% CI-1.1 to -0.4) until 2006 and then remained stable with a prevalence of 43.8 patients per 10,000 population in 2010. Among ≥85 years, there was a minor decrease (APC: -0.3%, 95% CI -0.5 to -0.1) in overall prevalence after 2002 from 1481 to 1453 patients per 10,000 population in 2010.

          Conclusion

          The overall prevalence of IS increased until 2000, but then remained stable followed by a slight decline. However, the prevalence of IS in the young increased through the study period. The absolute number of IS survivors has markedly increased, mainly because of demographic changes.

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          Most cited references19

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          Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002.

          G Lappas, Lena Björck, Simon Capewell … (2009)
          Coronary heart disease (CHD) mortality rates have been falling in Sweden since the 1980s. We used the previously validated IMPACT CHD model to examine how much of the mortality decrease in Sweden between 1986 and 2002 could be attributed to medical and surgical treatments, and how much to changes in cardiovascular risk factors. The IMPACT mortality model was used to combine and analyse data on uptake and effectiveness of cardiological treatments and risk factor trends in Sweden. The main data sources were official statistics, national quality of care registers, published trials and meta-analyses, and national population surveys. Between 1986 and 2002, CHD mortality rates in Sweden decreased by 53.4% in men and 52.0% in women aged 25-84 years. This resulted in 13 180 fewer deaths in 2002. Approximately 36% of this decrease was attributed to treatments in individuals and 55% to population risk factor reductions. Adverse trends were seen for diabetes and overweight. More than half of the substantial CHD mortality decrease in Sweden between 1986 and 2002 was attributable to reductions in major risk factors, mainly a large decrease in total serum cholesterol. These findings emphasize the value of a comprehensive strategy that promotes primary prevention and evidence-based medical treatments, especially secondary prevention.
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            Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986-2009.

            Lee Soderberg, D. Lundblad, L Holmgren … (2011)
            the incidence of cardiovascular disease has declined rapidly in Sweden since the 1980s. We explored changes in major cardiovascular risk factors in northern Sweden between 1986 and 2009. since 1986, six population surveys have been carried out in northern Sweden using procedures of the World Health Organization MONICA project. The population age range was 25-64 years in 1986 and 1990, and 25-74 years from 1994. Trends were analysed using generalized linear models. a total of 10586 subjects were included in the surveys. Blood pressure decreased by 4.9/3.9 mmHg in women and 1.8/1.5 mmHg in men aged 25-64 years between 1986 and 2009. In men and women aged 65-74 years, the decrease was 12.6/6.1 mmHg between 1994 and 2009. From 1994, the use of blood pressure-lowering drugs increased, particularly among the older subgroup. The prevalence of smoking halved between 1986 and 2009; 11% of women and 9% of men were smokers in 2009. Cholesterol levels decreased by 0.9 mmol L(-1) in the younger age group (25-64 years), and the use of lipid-lowering agents increased from 1994. Among subjects aged 25-64 years, one in five was obese in 2009, which was twice as many as in 1986, and body mass index (BMI) increased by 1.5 kg m(-2) , corresponding to an increase in weight of 4 kg. There was no further increase in BMI from 2004. The prevalence of diabetes did not change between 1986 and 2009. The proportion that received a university education increased markedly in all age groups, especially in women, during the study period. significant improvements were observed in major cardiovascular risk factors in northern Sweden between 1986 and 2009.
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              Prevalence of Individuals Experiencing the Effects of Stroke in Canada: Trends and Projections.

              Ruth Hall, Christina O'Callaghan, Mark Bayley … (2015)
              Previous estimates of the number and prevalence of individuals experiencing the effects of stroke in Canada are out of date and exclude critical population groups. It is essential to have complete data that report on stroke disability for monitoring and planning purposes. The objective was to provide an updated estimate of the number of individuals experiencing the effects of stroke in Canada (and its regions), trending since 2000 and forecasted prevalence to 2038.
              Article 0 comments Cited 62 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Tina Hernandez-Boussard: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 16 June 2017
                Publication date Collection: 2017
                Volume: 12
                Issue: 6
                Electronic Location Identifier: e0179658
                Affiliations
                [1 ]Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
                [2 ]Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
                [3 ]Health Metrics Unit, Department of public health and community medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
                [4 ]Institute of Biomedicine, Department of Clinical Pathology and Genetics, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
                Stanford University School of Medicine, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: KWG AR.

                • Data curation: KWG GL.

                • Formal analysis: KWG GL MA.

                • Funding acquisition: AR.

                • Investigation: AR.

                • Methodology: KWG ZM SN GL MA LB AR.

                • Project administration: KWG AR.

                • Resources: AR.

                • Software: GL.

                • Supervision: KWG AR.

                • Validation: KWG ZM SN GL MA LB CJ AR.

                • Visualization: KWG ZM SN GL MA LB CJ AR.

                • Writing – original draft: KWG.

                • Writing – review & editing: KWG ZM SN GL MA LB CJ AR.

                Author information
                http://orcid.org/0000-0002-3452-1969
                Article
                Publisher ID: PONE-D-17-02675
                DOI: 10.1371/journal.pone.0179658
                PMC ID: 5473590
                PubMed ID: 28622383
                SO-VID: a6424e93-ae44-40f5-a174-19d9f819463d
                Copyright © © 2017 Giang et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 20 January 2017
                Date accepted : 1 June 2017
                Page count
                Figures: 1, Tables: 2, Pages: 11
                Funding
                This work was supported by the Swedish Research Council, www.vr.se (grant numbers 340-2013-5187 and 521-2013-4236), the Swedish state under the agreement concerning research and education of doctors, www.researchweb.org/is/alfgbg (grant number ALFGBG-427301), The Swedish Heart and Lung Foundation, www.hjart-lungfonden.se (grant numbers 2015-0438 and 2015-0243). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Cell Biology
                Subject: Cellular Types
                Subject: Animal Cells
                Subject: Immune Cells
                Subject: Antigen-Presenting Cells
                Subject: Biology and Life Sciences
                Subject: Immunology
                Subject: Immune Cells
                Subject: Antigen-Presenting Cells
                Subject: Medicine and Health Sciences
                Subject: Immunology
                Subject: Immune Cells
                Subject: Antigen-Presenting Cells
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Medicine and Health Sciences
                Subject: Neurology
                Subject: Cerebrovascular Diseases
                Subject: Stroke
                Subject: Ischemic Stroke
                Subject: Medicine and Health Sciences
                Subject: Vascular Medicine
                Subject: Stroke
                Subject: Ischemic Stroke
                Subject: People and Places
                Subject: Geographical Locations
                Subject: Europe
                Subject: Sweden
                Subject: People and Places
                Subject: Demography
                Subject: Computer and Information Sciences
                Subject: Computer Software
                Subject: Medicine and Health Sciences
                Subject: Neurology
                Subject: Cerebrovascular Diseases
                Subject: Stroke
                Subject: Medicine and Health Sciences
                Subject: Vascular Medicine
                Subject: Stroke
                Subject: Research and Analysis Methods
                Subject: Imaging Techniques
                Subject: Neuroimaging
                Subject: Computed Axial Tomography
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Neuroimaging
                Subject: Computed Axial Tomography
                Subject: Medicine and Health Sciences
                Subject: Diagnostic Medicine
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Computed Axial Tomography
                Subject: Research and Analysis Methods
                Subject: Imaging Techniques
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Computed Axial Tomography
                Subject: Medicine and Health Sciences
                Subject: Radiology and Imaging
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Computed Axial Tomography
                Custom metadata
                Data Availability The computations for this study are based on individual data from the Swedish Inpatient register held by the National Board of Health and Welfare which are not publicly available. All personal data are subjected to secrecy in accordance with the Swedish Public Access to Information and Secrecy Act (OSL, 2009:400). The dataset can be made available to researchers upon request pending approval by the appropriate ethics committee. Formal requests of the data should be made to http://www.socialstyrelsen.se/statistics which can also provide information about the register and persons to contact for queries. All relevant aggregated data on number of cases per year, age and gender are already contained within the paper, supporting information files and its supporting information. Population data are available at Human Mortality Database at www.mortality.org.

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                ScienceOpen disciplines: Uncategorized

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