Dijon's vanishing lead with regard to low incidence of stroke

Towards the end of the 20th century, the city of Dijon, France, had a lower incidence of stroke than that found in other studies. It was hypothesized that genetic and environmental factors were responsible for this so-called French paradox. We aim to evaluate recent changes in stroke incidence to determine whether or not the Dijon exception still exists. The population-based stroke registry of Dijon ascertained all first-ever strokes from 2000 to 2006. We calculated incidence to compare recent results with those obtained from a previous study period (1985-1999) and those of other population-based studies covering both the end of the 20th and the beginning of the 21st century. From 2000 to 2006, 1205 strokes were recorded. Crude and age-standardized incidence (to European and World population) rates were respectively 113, 107 and 72/100 000/year. No change was observed between 1985-1999 and 2000-2006, whereas other studies reported declining incidence. The incidence of stroke in Dijon remained lower than that found in similar studies, but the difference compared with results observed for the 20th century is shrinking. Therefore, the Dijon exception is decreasing, suggesting that it was rather an advance in prevention strategies that has diminished.