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Document 1 of 1 Incidence of stroke in women in Auckland, New Zealand. Ethnic trends over two decades: 1981-2003 Author: Dyall, Lorna; Carter, Kristie; Bonita, Ruth; Anderson, Craig; Feigin, Valery; Kerse, Ngaire; Brown, Paul;of the Auckland Regional Community Stroke (ARCOS) Study Group, on behalf ProQuest document link Abstract: Background and purpose Although women have a greater lifetime risk of stroke than men, along withother gender differences in stroke, there is lack of reliable data on long-term trends in stroke in women. Thispaper presents the results of three population-based registers in Auckland (1981-1982, 1991-1992, and 2002-2003) which aimed to determine the trends in the incidence of stroke in New Zealand. This paper reports on theburden of stroke in women across different ethnic groups over the study period from 1981 to 2003. Methods Three studies using similar methodology and overlapping case finding methods have been conductedin New Zealand to estimate trends in the incidence and outcome of stroke. The studies are recognised asmeeting the 'ideal' criteria for stroke incidence and identify all first-ever and recurrent strokes in residents (aged?15 years) the population of Auckland, New Zealand in the 12-month periods from 1981-1982, 1991-1992, and2002-2003. There were totals of 307,578 strokes among women in 1981, 372,642 in 1991, and 470,727 in2001, according to each Census representing over 50% of the population at each period (51%-54%). The WHOstandard world population was used for direct age standardisation of annual rates (per 100,000 population),reported with 95% confidence intervals (CI). Results The proportion of women who have experienced a stroke did not change markedly over the studyperiod but there were ethnic differences emerging which were related to population changes within the NewZealand population. Standardised stroke incidence in women was relatively stable across the three studyperiods (1981-1982), 133 [95% CI 118-151]; (1991-1992), 143 [95% CI 116-241]; and (2002-2003), 124 [95%CI 115-134]). However, a significant decline of 14% (95% CI 2%-29%) in rates of first-ever stroke was foundbetween 1991-1992 and 2002-2003 in women. In contrast to the significant declines in event rates in Europeanwomen over two decades (Rate ratio 0.84, 95% CI 0.73-0.96), increasing trends in event rates in Pacific womenwere observed (2.71 95% CI 1.00-7.29). The rate of stroke for M?ori women did not change significantly overtime. Over half of the women who had a stroke event reported that they had high blood pressure; one in four reportedthat they had diabetes. The proportion of women who smoked declined over time but increases in body massindex (BMI) indicated weight gains in women over time. These trends were consistent across ethnic groups. Women's survival after 1 month following their stroke has improved by 39% (p<0.0001) over the 20-year period.Favourable changes in early survival were most pronounced in European women. Conclusions There was a modest decline in stroke incidence in women (overall and for New Zealand Europeanwomen in particular) in Auckland over the past 20 years but there also was a trend towards increasing strokeincidence in M?ori, Pacific, and Asian women. These divergent trends are likely to be associated with differenttrends in the prevalence of risk factors in these ethnic populations. Targeted stroke prevention programmes areneeded in New Zealand to meet the needs of specific ethnic groups as well as the needs of providing ongoingcare and support to women following their stroke. Subject: Stroke; Womens health; Cardiovascular disease; Fatalities; Disability; Gender; Confidence intervals;Trends; Censuses; Cultural differences; Ethnicity; Mortality; Mens health; Studies; MeSH: Adolescent, Adult, Comorbidity, Diabetes Mellitus -- epidemiology, Diabetic Angiopathies --epidemiology, Female, Humans, Incidence, New Zealand -- epidemiology, Risk Factors, Smoking --epidemiology, Socioeconomic Factors, Urban Population -- statistics & numerical data, Stroke -- epidemiology

(major), Stroke -- mortality (major) Corporate/institutional author: Auckland Regional Community Stroke (ARCOS) Study Group Publication title: The New Zealand Medical Journal (Online) Volume: 119 Issue: 1245 Pages: U2309 Publication year: 2006 Publication date: Nov 17, 2006 Year: 2006 Section: Original Articles Publisher: New Zealand Medical Association (NZMA) Place of publication: Christchurch Country of publication: New Zealand Publication subject: Medical Sciences ISSN: 11758716 Source type: Scholarly Journals Language of publication: English Document type: Journal Article Accession number: 17146484 ProQuest document ID: 1034229969 Document URL: http://search.proquest.com/docview/1034229969?accountid=50673 Copyright: Copyright New Zealand Medical Association (NZMA) Nov 17, 2006 Last updated: 2014-03-28 Database: ProQuest Medical Library

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