Stroke mortality and trends from 1990 to 2006 in 39 countries from Europe and Central Asia: Implications for control of high blood pressure

Josep Redon, Michael H. Olsen, Richard S. Cooper, Oscar Zurriaga, Miguel A. Martinez-Beneito, Stephane Laurent, Renata Cifkova, Antonio Coca, Guiseppe Mancia

Research output: Contribution to journalArticlepeer-review


AimsThe aim of the present study was to extend our understanding of international trends in stroke and major sequelae in Europe and countries peripheral to Europe by assessing: (1) current mortality rates, (2) the most recent 15-year prevalence trends, and (3) the relationship between systolic blood pressure in community surveys and national stroke mortality. Methods and resultsData were obtained from the World Health Organization (WHO, and represent national vital statistics as reported by 39 countries (European and Central Asian countries) using a standard format and population-based cardiovascular surveys. Total numbers of deaths by stroke (International Classification of Diseases 430438, 444) and the age, sex-adjusted incidence rates were obtained and grouped according to three standard demographic categories: A, B, and C (WHO). A Bayesian linear mixed effect model was fitted to the annual mortality rates. Higher rates of stroke mortality were observed for B and C group countries as compared with those countries belonging to Group A (e.g. Bulgaria 273.9 and 281.1; Israel 37.7 and 45.4 per 100 000 men and women, respectively). Even though the mortality rates within the country groupings were relatively similar, countries with marked deviation from the average were observed, mainly in Groups B and C. Stroke mortality decreased sharply in Group A during the period of study; conversely it had increased substantially in Group B and to a lesser extent in Group C. For both sexes markedly higher rates were noted moving from west to east, with some exceptions. Conclusion We have entered a period of rapidly increasing international inequality in stroke risk, where countries with low adult mortality in the latter 20th century extended their downward trend and countries with moderate as well as high mortality have on average seen unprecedented increases in death rates from stroke.

Original languageEnglish
Pages (from-to)1424-1431
Number of pages8
JournalEuropean Heart Journal
Issue number11
Publication statusPublished - Jun 2011


  • Europe mortality
  • Hypertension control
  • Stroke mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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