Community-Based Stroke Incidence Trends From the 1970s Through the 1980s in East Germany

BACKGROUND AND PURPOSE: Stroke mortality has declined in most industrialized countries, but incidence rates have increased in some populations while they remained stable or even decreased in others. This study reports stroke incidence trends in East Germany over the past decades. METHODS: Prospective community-based stroke registers were run in East Germany over two different time periods: 1972 through 1973 in the Berlin-Lichtenberg district and 1985 through 1988 in 14 districts in the central and southern part of the country. Stroke cases were collected and validated in a uniform way using both the World Health Organization (WHO) recommendations for community stroke registers and the guidelines of the WHO MONICA protocol. RESULTS: Annual age-adjusted incidence rates of first-ever strokes rose among men aged 25 to 64 years from 48.4 per 100,000 in 1972 through 1973 to 88.0 per 100,000 in 1985 through 1988 (P < .05); incidence rates remained unchanged among women in this age range (52.6 and 52.5 per 100,000, respectively). Age-specific incidence rates increased among men in all age groups up to 74 years. Rising stroke rates were also observed in women under 55 years and between the ages of 65 and 74 years, whereas in women aged 55 to 65 years incidence rates declined by more than a third (P < .05). During the period from 1985 through 1988, stroke rates did not change. CONCLUSIONS: An increase in stroke incidence was detected that can be associated with a deteriorating risk factor profile in the East German population and, in particular, with hypertension in men.