Abstract

Cerebrovascular disease (stroke) is the second cause of death and among the top five causes of morbidity in many developed and developing countries. The coincidence of trends of stroke and coronary heart disease mortalities is of question in different countries. This study aims to investigate patterns of increase and decrease of stroke mortality in 48 different countries. The mortality curves of stroke for 48 countries that had reliable data and met other selection criteria were examined using age-standardised death rates for 35–74 years from the WHO. Annual male mortality rates for individual countries from 1950 to 2005 were plotted and a table and graph were used to classify countries by magnitude, pattern and timing of stroke mortality. The natural history of stroke epidemics varies markedly among countries. Different stroke patterns are distinguishable; including “declining” (since the inception of data or 1950), “rise and fall”, “rising” (first part of epidemic), and “flat” (no epidemic yet). Further, epidemic peaks were higher in Asia, in particular Japan at 433/105, the former Soviet states at 388/105 and East Europe at 301/105 and lowest in Canada and Australia at 29/105. The different dates of mortality downturn could reflect the times when pharmaceutical treatment of hypertension started to be effective in sufficient numbers of the high risk population and/or there were significant changes in salt consumption. This could be translated to policy interventions for stroke control in countries with rising trend of the disease.