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European Heart Journal

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There is growing inequality in the proportion of people who die from stroke between different countries in Europe and central Asia, largely due to varying treatment of hypertension, according to a multi-national study published recently in the European Heart Journal.1

In countries where the proportion of stroke deaths had been low at the end of the 20th century, death rates were found to have continued decreasing sharply; these countries include most of the western European nations. But in countries where stroke deaths were moderate or high, the study revealed “a further unprecedented increase in this cause of death” say its authors.

Researchers analysed stroke data from the World Health Organization (WHO) for 35 countries between 1990 and 2006. The countries were grouped according to WHO classifications into three demographic categories: group A, countries with very low child (under five years) and adult (15-59 years) mortality; group B, countries with low child and adult mortality; group C, countries with low child and high adult mortality.

In 2002 there were a total of 1,226,144 deaths from stroke, the authors found, with higher death rates tending to occur in the countries of groups B and C than in those of group A (e.g. Israel had 38 per 100,000 inhabitants, Russia had 274 per 100,000).

When the researchers examined the trends over time, they found that in group A, deaths from stroke decreased sharply from 1990 to 2006 by approximately 40 per 100,000 of the population. In contrast, death rates increased by about 35-40 per 100,000 in group B, and by about 20 per 100,000 in group C.

The authors write: “If we assume that stroke mortality can serve as a proxy for average BP [blood pressure] in a population, the data presented here clearly demonstrate the necessity to adopt actions to increase the diagnosis, treatment and hypertension control in the countries where the burden of hypertension sequelae is still growing. Policies to increase the rate of BP control offer the best approach, while primary prevention strategies must also be implemented”.

Lead author Professor Josep Redon, University of Valencia, Spain concludes: “We hope that this paper will be a call to action in the face of the huge impact of stroke all over Europe.”


1 Redon J, Olsen MH, Cooper RS, et al.  Stroke mortality and trends from 1990 to 2006 in 39 countries from Europe and Central Asia: implications for control of high blood pressure.  Eur Heart J 2011; doi:10.1093/eurheartj/ehr045.

Published on: June 8, 2011

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