Papers

Do changes in cardiovascular risk factors explain changes in mortality from stroke in Finland?

^a Department of Epidemiology and Health Promotion, National Public Health Institute Mannerheimintie 166, FIN-00300 Helsinki, Finland

Correspondence to: Dr Vartiainen.

Abstract

Objectives: To estimate the extent to which the changes in the main cardiovascular risk factors (blood pressure, smoking, and serum cholesterol concentration) can explain the observed changes in mortality from stroke in Finland during the past 20 years.
Design: Predicted changes in mortality from cerebrovascular disease mortality were calculated by a proportional hazards model from data obtained in cross sectional population surveys in 1972, 1977, 1982, 1987, and 1992. Predicted changes were compared with the observed changes in mortality statistics.
Setting: North Karelia and Kuopio provinces, Finland.
Subjects: 16741 men and 16389 women aged 30-59 randomly selected from the national population register, of whom 14054 men and 14546 women participated.
Main outcome measures: Levels of risk factors and predicted and observed changes in mortality from cerebrovascular disease.
Results: The observed changes in diastolic blood pressure, total serum cholesterol concentration, and smoking in the population from 1972 to 1992 predicted a 44% fall in mortality from stroke in men and changes in diastolic blood pressure and smoking predicted a 34% fall in women. The observed fall in mortality from stroke was 66% in men and 60% in women.
Conclusions: Two thirds of the fall in mortality from stroke in men and half in women can be explained by changes in the three main cardiovascular risk factors.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study

Shah Ebrahim, Joohon Sung, Yun-Mi Song, Robert L Ferrer, Debbie A Lawlor, and George Davey Smith
BMJ 2006 333: 22. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Harald, K, Koskinen, S, Jousilahti, P, Torppa, J, Vartiainen, E, Salomaa, V (2008). Changes in traditional risk factors no longer explain time trends in cardiovascular mortality and its socioeconomic differences. J. Epidemiol. Community Health 62: 251-257 [Abstract] [Full text]  
• Ebrahim, S., Sung, J., Song, Y.-M., Ferrer, R. L, Lawlor, D. A, Smith, G. D. (2006). Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study. BMJ 333: 22- [Abstract] [Full text]  
• Jakovljevic, D., on behalf of the FINSTROKE Register Group, (2004). Day of the Week and Ischemic Stroke: Is It Monday High or Sunday Low?. Stroke 35: 2089-2093 [Abstract] [Full text]  
• Kattainen, A., Reunanen, A., Koskinen, S., Martelin, T., Knekt, P., Aromaa, A. (2002). Secular changes in prevalence of cardiovascular diseases in elderly Finns. Scand J Public Health 30: 274-280 [Abstract]  
• Tolonen, H., Mahonen, M., Asplund, K., Rastenyte, D., Kuulasmaa, K., Vanuzzo, D., Tuomilehto, J. (2002). Do Trends in Population Levels of Blood Pressure and Other Cardiovascular Risk Factors Explain Trends in Stroke Event Rates?: Comparisons of 15 Populations in 9 Countries Within the WHO MONICA Stroke Project. Stroke 33: 2367-2375 [Abstract] [Full text]  
• Levi, F, Lucchini, F, Negri, E, La Vecchia, C (2002). Trends in mortality from cardiovascular and cerebrovascular diseases in Europe and other areas of the world. Heart 88: 119-124 [Abstract] [Full text]  
• Amarenco, P. (2001). Hypercholesterolemia, lipid-lowering agents, and the risk for brain infarction. Neurology 57: S35-44 [Abstract] [Full text]  
• Martikainen, P, Valkonen, T, Martelin, T (2001). Change in male and female life expectancy by social class: decomposition by age and cause of death in Finland 1971-95. J. Epidemiol. Community Health 55: 494-499 [Abstract] [Full text]  
• Ruigrok, Y. M., Buskens, E., Rinkel, G. J. E. (2001). Attributable Risk of Common and Rare Determinants of Subarachnoid Hemorrhage. Stroke 32: 1173-1175 [Abstract] [Full text]  
• Numminen, H., Kaste, M., Aho, K., Waltimo, O., Kotila, M. (2000). Decreased Severity of Brain Infarct Can in Part Explain the Decreasing Case Fatality Rate of Stroke. Stroke 31: 651-655 [Abstract] [Full text]  
• Artalejo, F. R., Guallar-Castillon, P., Banegas, J. R. B., Manzano, B. d. A., Calero, J. d. R. (1998). Consumption of Fruit and Wine and the Decline in Cerebrovascular Disease Mortality in Spain (1975–1993). Stroke 29: 1556-1561 [Abstract] [Full text]  
• Immonen-Raiha, P., Mahonen, M., Tuomilehto, J., Salomaa, V., Kaarsalo, E., Narva, E. V., Salmi, K., Sarti, C., Sivenius, J., Alhainen, K., Torppa, J. (1997). Trends in Case-Fatality of Stroke in Finland During 1983 to 1992. Stroke 28: 2493-2499 [Abstract] [Full text]  
• Ellekjær, H., Holmen, J., Indredavik, B., Terent, A. (1997). Epidemiology of Stroke in Innherred, Norway, 1994 to 1996 : Incidence and 30-Day Case-Fatality Rate. Stroke 28: 2180-2184 [Abstract] [Full text]  
• Jousilahti, P., Rastenyte, D., Tuomilehto, J., Sarti, C., Vartiainen, E. (1997). Parental History of Cardiovascular Disease and Risk of Stroke : A Prospective Follow-up of 14 371 Middle-aged Men and Women in Finland. Stroke 28: 1361-1366 [Abstract] [Full text]  
• (1997). Stroke Incidence and Mortality Correlated to Stroke Risk Factors in the WHO MONICA Project : An Ecological Study of 18 Populations. Stroke 28: 1367-1374 [Abstract] [Full text]  
• Tuomilehto, J., Rastenyte, D., Sivenius, J., Sarti, C., Immonen-Raiha, P., Kaarsalo, E., Kuulasmaa, K., Narva, E. V., Salomaa, V., Salmi, K., Torppa, J. (1996). Ten-Year Trends in Stroke Incidence and Mortality in the FINMONICA Stroke Study. Stroke 27: 825-832 [Abstract] [Full text]  
• Linn, F.H.H., Rinkel, G.J.E., Algra, A., van Gijn, J. (1996). Incidence of Subarachnoid Hemorrhage : Role of Region, Year, and Rate of Computed Tomography: A Meta-Analysis. Stroke 27: 625-629 [Abstract] [Full text]  
• Teunissen, L. L., Rinkel, G. J.E., Algra, A., van Gijn, J. (1996). Risk Factors for Subarachnoid Hemorrhage : A Systematic Review. Stroke 27: 544-549 [Abstract] [Full text]  
• Mitchell, G. (1996). A qualitative study of older women's perceptions of control, health and ageing. Health Education Journal 55: 267-274 [Abstract]