Twenty years trends in mortality rates from stroke in Klaipeda.

BACKGROUND: During the past decades, mortality from stroke decreased in many western European countries; however, changes concerning long-term stroke mortality in eastern European countries are less evident. OBJECTIVE: To assess age- and gender-specific trends in stroke mortality in Klaipeda (Lithuania) from 1994 to 2013. DESIGN: Descriptive epidemiological study. SETTING/SUBJECTS: Permanent population of Klaipeda. METHODS: Data on 2509 permanent residents of Klaipeda aged 35-79 years who died from stroke between 1994 and 2013 were gathered. Directly, age-standardized (European population) stroke mortality rates were analyzed using joinpoint regression separately for specific age groups (35-64, 65-79, and 35-79 years) and by gender. Annual percentage change (APC) and 95% CIs were presented. RESULTS: Stroke mortality in the 35- to 79-year-old age group peaked in 1994-1997, it then decreased by -9.9% (95% CI: -18.7, -0.2) yearly up until 2001 and leveled off by -0.2% (-5.1, 4.9) between 2001 and 2013. Among men aged 35-64 years, mortality decreased substantially by 12.8% (-21.5, -3.3) per year from 1994 to 2001 and turned positive by 6.3% (0.8, 12.1) between 2000 and 2013. Among women aged 35-64 years, mortality decreased significantly by 15.5% (-28.1, -0.7) from 1994 to 2000. There was evidence of recent plateauing of trends for 35- to 64-year-old women between 2000 and 2013. In the 65- to 79-year-old age group, mortality decreased from 1994 onward yearly by -5.5% (-7.9, -3.0) in women and by -3.3% (-5.6, -0.9) in men. CONCLUSIONS: Joinpoint regression revealed steadily decreasing trend in stroke mortality between 1994 and 2001. The decline in death rates flattened out in the recent decade. Mortality rates varied among age groups and were more pronounced in adults aged 35-64 years. It is essential to monitor and manage stroke risk factors, especially among middle-aged population.

Stroke mortality trends in the population of Klaipeda from 1994 to 2008.

UNLABELLED: The objective of the study was to evaluate the trends in stroke mortality in the population of Klaipeda aged 35-79 years from 1994 to 2008. MATERIAL AND METHODS: Mortality data on all permanent residents of Klaipeda aged 35-79 years who died from stroke in 1994-2008 were gathered for the study. All death certificates of permanent residents of Klaipeda aged 35-79 years who died during 1994-2008 were examined in this study. The International Classification of Diseases (ICD-9 codes 430-436, and ICD-10 codes I60-I64) was used. Sex-specific mortality rates were standardized according to the Segi's world population; all the mortality rates were calculated per 100 000 population per year. Trends in stroke mortality were estimated using log-linear regression models. Sex-specific mortality rates and trends were calculated for 3 age groups (35-79, 35-64, and 65-79 years). RESULTS: During the entire study period (1994-2008), a marked decline in stroke mortality with a clear slowdown after 2002 was observed. The average annual percent changes in mortality rates for men and women aged 35-79 years were -4.6% (P=0.041) and -6.5% (P=0.002), respectively. From 1994 to 2002, the stroke mortality rate decreased consistently among both Klaipeda men and women aged 35-64 years (20.4% per year, P=0.002, and 14.7% per year, P=0.006, respectively) and in the elderly population aged 65-79 years (13.8% per year, P=0.005; and 12% per year, P=0.019). During 2003-2008, stroke mortality increased by 16.3% per year in middle-aged men (35-64 years), whereas among women (aged 35-64 and 65-79 years) and elderly men (aged 65-79 years), the age-adjusted mortality rate remained relatively unchanged. CONCLUSIONS: Among both men and women, the mortality rates from stroke sharply declined between 1994 and 2008 with a clear slowdown in the decline after 2002. Stroke mortality increased significantly among middle-aged men from 2003, while it remained without significant changes among women of the same age and both elderly men and women.