STROKE EPIDEMIOLOGY IN EUROPE

The information on epidemiology of stroke in Europe comes from mortality statistics and incidence studies. The purpose of this paper was to review the data on mortality, incidence, case fatality and stroke care in Europe, and to discuss geographical and temporal trends, taking into account methodological problems. The available updated studies on mortality and incidence were reviewed. Considering methodological characteristics, incidence studies were evaluated separately for ''ideal'' and ''non-ideal'' studies. The preliminary data of the ongoing EC Stroke Project were also examined. Marked differences are observed in mortality rates across European countries. Rates are higher in Eastern compared to Western countries. Temporal trends are decreasing in Western and increasing in Eastern countries. Incidence data are scanty and probably not fully representative. Preliminary observations show that marked differences exist in stroke care across different countries. Geographical and temporal trends in mortality and morbidity may reflect both methodological inhomogeneity and differences in prevalence of risk factors, incidence and survival. Differences in socio-economical level may have an impact on stroke care, and may indirectly influence stroke frequency measures. A collaborative effort is needed for standardizing the methodologies, checking the reliability of data, and examining more extensively trends in risk factors and stroke care. This may make it possible to optimize the cost effectiveness of management of stroke patients in Europe.