TY - JOUR
T1 - Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study
AU - Madsen, Tracy E.
AU - Khoury, Jane
AU - Alwell, Kathleen
AU - Moomaw, Charles J.
AU - Rademacher, Eric
AU - Flaherty, Matthew L.
AU - Woo, Daniel
AU - MacKey, Jason
AU - De Los Rios La Rosa, Felipe
AU - Martini, Sharyl
AU - Ferioli, Simona
AU - Adeoye, Opeolu
AU - Khatri, Pooja
AU - Broderick, Joseph P.
AU - Kissela, Brett M.
AU - Kleindorfer, Dawn
N1 - Funding Information:
This study was funded by a grant from the National Institutes of Neurologic Disorders and Stroke (grant RO1 NS 30678).
Funding Information:
T. Madsen reports no disclosures relevant to the manuscript. J. Khoury is funded by a research grant (R01NS30678). K. Alwell is funded by a research grant (R01NS30678). C. Moomaw is funded by a research grant (R01NS30678). E. Rademacher is funded by a research grant (R01NS30678). M. Flaherty is funded by a research grant (R01NS30678). D. Woo is funded by a research grant (R01NS30678). J. Mackey is funded by a research grant (R01NS30678). F. De Los Rios La Rosa is a member of Boehringer Ingelheim speaker’s bureau. S. Martini reports no disclosures relevant to the manuscript. S. Ferioli is funded by a research grant (R01NS30678). O. Adeoye reports no disclosures relevant to the manuscript. P. Khatri’s Department of Neurology at University of Cincinnati received financial support for her research-related activities from Genentech (PRISMS Trial Lead PI), Penumbra (THERAPY Trial Neurology PI), and Biogen (DSMB member). J. Broderick reports no disclosures relevant to the manuscript. B. Kissela is funded by a research grant (R01NS30678). D. Kleindorfer is funded by a research grant (R01NS30678). Go to Neurology.org for full disclosures.
Publisher Copyright:
© 2017 American Academy of Neurology.
PY - 2017/9/5
Y1 - 2017/9/5
N2 - Recent data suggest stroke incidence is decreasing over time, but it is unknown whether incidence is decreasing in women and men to the same extent. Methods: Within our population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all hospitals during July 1993-June 1994 and calendar years 1999, 2005, and 2010. A sampling scheme was used to ascertain out-of-hospital cases. Sex-specific incidence rates per 100,000 among black and white participants, age- A nd race-adjusted, were standardized to the 2000 US Census population. Trends over time by sex were compared; a Bonferroni correction was applied for multiple comparisons. Results: Over the 4 study periods, there were 7,710 incident strokes; 57.2% (n = 4,412) were women. Women were older than men (mean ± SE 72.4 ± 0.34 vs 68.2 ± 0.32, p < 0.001). Incidence of all strokes decreased over time in men (263 [confidence interval 246-281] to 192 [179-205], p < 0.001) but not in women (217 [205-230] to 198 [187-210], p = 0.15). Similar sex differences were seen for ischemic stroke (men, 238 [223-257] to 165 [153-177], p < 0.01; women, 193 [181-205] to 173 [162-184], p = 0.09). Incidence of all strokes and of ischemic strokes was similar between women and men in 2010. Incidence of intracerebral hemorrhage and subarachnoid hemorrhage were stable over time in both sexes. Conclusions: Decreases in stroke incidence over time are driven by a decrease in ischemic stroke in men. Contrary to previous study periods, stroke incidence rates were similar by sex in 2010. Future research is needed to understand why the decrease in ischemic stroke incidence is more pronounced in men.
AB - Recent data suggest stroke incidence is decreasing over time, but it is unknown whether incidence is decreasing in women and men to the same extent. Methods: Within our population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all hospitals during July 1993-June 1994 and calendar years 1999, 2005, and 2010. A sampling scheme was used to ascertain out-of-hospital cases. Sex-specific incidence rates per 100,000 among black and white participants, age- A nd race-adjusted, were standardized to the 2000 US Census population. Trends over time by sex were compared; a Bonferroni correction was applied for multiple comparisons. Results: Over the 4 study periods, there were 7,710 incident strokes; 57.2% (n = 4,412) were women. Women were older than men (mean ± SE 72.4 ± 0.34 vs 68.2 ± 0.32, p < 0.001). Incidence of all strokes decreased over time in men (263 [confidence interval 246-281] to 192 [179-205], p < 0.001) but not in women (217 [205-230] to 198 [187-210], p = 0.15). Similar sex differences were seen for ischemic stroke (men, 238 [223-257] to 165 [153-177], p < 0.01; women, 193 [181-205] to 173 [162-184], p = 0.09). Incidence of all strokes and of ischemic strokes was similar between women and men in 2010. Incidence of intracerebral hemorrhage and subarachnoid hemorrhage were stable over time in both sexes. Conclusions: Decreases in stroke incidence over time are driven by a decrease in ischemic stroke in men. Contrary to previous study periods, stroke incidence rates were similar by sex in 2010. Future research is needed to understand why the decrease in ischemic stroke incidence is more pronounced in men.
UR - http://www.scopus.com/inward/record.url?scp=85028803907&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000004325
DO - 10.1212/WNL.0000000000004325
M3 - Article
C2 - 28794254
AN - SCOPUS:85028803907
SN - 0028-3878
VL - 89
SP - 990
EP - 996
JO - Neurology
JF - Neurology
IS - 10
ER -