Trend in stroke incidence in Shiga, Japan, 1990-2010

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Masato Nagai, PhD , Shiga University of Medical Science, Otsu, Japan
Yoshikuni Kita, PhD , Shiga University of Medical Science, Otsu, Shiga, Japan
Naoyuki Takashima, PhD , Shiga University of Medical Science, Otsu, Shiga, Japan
Yoshitaka Murakami, PhD , Shiga University of Medical Science, Otsu, Japan
Robert D Abbott, PhD , Shiga University of Medical Science, Otsu, Shiga, Japan
Tanvir C Turin, PhD , University of Calgary, Calgary, AB, Canada
Nahid Rumana, PhD , Alberta Health Services, Calgary, AB, Canada
Katsuyuki Miura, MD , Shiga University of Medical Science, Otsu, Japan
Hirotsugu Ueshima, MD , Shiga University of Medical Science, Otsu, Japan
INTRODUCTION:  

Stroke mortality and incidence began to decline in Japan in the 1960s.  Our population-based registry of stroke incidence using data collected from 1990 to 2001 has previously shown that this decline may have levelled off or slowed down.  Whether this pattern of change continues in the decade that follows is uncertain.  We examined the recent trend in stroke incidence in Japan using the same registry with follow-up extended to 2010.

METHODS:

Data were obtained from the Takashima Stroke Registry covering approximately 55,000 residents of Takashima Country in Shiga, Japan.  We estimated the gender-specific age-adjusted first-ever stroke incidence rates (/100,000 person-years) and their 95% confidence intervals (95%CI) using Byar’s method in 3 year intervals during 1990-2010.  For age adjustment, we used direct standardization based on the world standard population distribution in 2000-2025 from the World Health Organization.  Ages were categorized into ranges of <35, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 years.

RESULTS:  

There were 1,224 registered first-ever stroke cases in men and 1,083 in women.  The age-adjusted incidence of stroke nearly halved in both genders during 1990-2010.  The declining trend has been continued after 2001, in spite of an average age increase of approximately 8 years in the 21 years of follow-up.  Incidence rates across the seven observation periods in men were 161.4 (95%CI: 139.3-186.0) in 1990-1992, 151.1 (130.5-173.9) in 1993-1995, 114.9 (97.6-134.4) in 1996-1998, 135.2 (116.4-156.0) in 1999-2001, 90.1 (75.1-106.9) in 2002-2004, 79.9 (66.1-95.4) in 2005-2007, and 76.3 (63.2-91.1) in 2008-2010 (Ptrend<0.001).  In women, the rates were 88.0 (73.3-104.5), 94.6 (79.8-111.2), 82.3 (68.9-97.4), 81.4 (68.7-95.5), 55.5 (45.5-66.8), 39.9 (31.3-49.9), and 42.7 (34.2-52.2) (Ptrend<0.001).

CONCLUSIONS:

The present study showed that significant and continuous declining trends of stroke incidence in Japan was observed during recent the 2 decades. This decline occurred in spite of the aging population in Takashima.

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