Physicians' Academy for Cardiovascular Education

Risk factor changes account for 57% of decrease in ischaemic stroke incidence

Declining Incidence of Ischemic Stroke: What Is the Impact of Changing Risk Factors?

The Tromsø Study 1995 to 2012

Literature - Vangen-Lønne AM, Wilsgaard T, Johnsen SH, et al. - Stroke. 2017; 48: published online ahead of print


Stroke mortality rates have declined during the last decades due to a declining stroke incidence and a reduced case fatality [1]. A limited proportion of decreased stroke incidence can be explained by the improvement of risk factor control between 1982 and 1995 [2-4].

In this study, the impact of modifiable risk factors on the changing incidence of ischaemic stroke (IS) between 1995 and 2012 was estimated, using individual person data from repeated surveys in a general population (n=27 936).

Main results


In a general population analysis with data from 1995 to 2012, risk factor changes accounted for 57% of the decrease in IS incidence. The most important contributors were the declines in mean SBP and prevalence of smoking, whereas the increasing DM prevalence contributed negatively to the IS incidence. These findings confer to the need to further reduce modifiable risk factors and encourage future research of less well-recognized risk factors.


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