Stroke death rates on the decline in Europe

However decline plateauing in Ireland
  • Deborah Condon

Death rates from conditions that affect the blood supply to the brain, such as stroke, are on the decline in Europe overall. However in some countries, including Ireland, this decline is plateauing, a new study has revealed.

Cerebrovascular disease, which includes strokes and mini-strokes, is Europe's second largest cause of death after heart disease, accounting for 12% of all deaths in women and 9% in men.

UK researchers used data from the World Health Organization (WHO) to examine mortality trends in relation to three types of cerebrovascular disease between 1980 and 2016:
-Ischaemic stroke (caused by a lack of blood flow to the brain)
-Haemorrhagic stroke (caused by bleeding in the brain)
-Sub-arachnoid haemorrhage (bleeding occurs between the brain and the surrounding membrane).

The study found that death rates from these conditions fell overall by 65% in 33 countries throughout Europe. They rose in just three countries for men (Azerbaijan, Georgia and Tajikistan) and two for women (Azerbaijan and Uzbekistan).

However, the researchers noted evidence of a recent plateau in trends, which is when the rate of reductions in mortality in the most recent period is less pronounced than in the previous period.

This leveling off of death rates was noted in women in six countries, including Ireland, France and Germany. It was noted in men in seven countries, including France, Germany and Greece.

"Over the last 35 years there have been large overall declines in deaths from cerebrovascular disease in the majority of European countries. While these declines have continued in more than half of the countries, these have not been consistent across Europe and our analysis has revealed evidence of recent plateauing and even increases in stroke deaths in certain countries.

"We have seen this in both sexes and in countries across the whole of Europe, particularly in eastern and central Europe. We have also found differences in death rates by stroke type. Therefore, it is not enough to consider cerebrovascular disease as just one condition and we must consider each individual stroke type," commented lead researcher, Dr Nick Townsend, of the University of Bath.

He said it is important to figure out why mortality rates are reducing in some countries, but not all.

"In addition, we only studied between-country inequalities, but we must consider within-country inequalities as well if we are to have an impact on the disease," he added.

While the study did not assess the reason behind these changes, the researchers said it was unlikely that there was a single reason for the overall decline in cerebrovascular disease.

Improvements in disease treatment, as well as prevention strategies that encourage people to improve their lifestyles by quitting smoking, drinking less alcohol, eating healthier and exercising more, all most likely play a part.

However, reasons for mortality rates leveling off, or even increasing in some countries, may be partly due to the increasing prevalence of obesity and diabetes, they warned.

Details of these findings are published in the European Heart Journal.


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