Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management: population-based cohort study. Gulliford, M. C., Charlton, J., Rudd, A., Wolfe, C. D., & Toschke, A. M. Journal of Neurology, Neurosurgery, and Psychiatry, 81(4):416--422, April, 2010.
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BACKGROUND: The authors estimated trends in 1-year case-fatality of stroke in relation to changes in vascular risk management from 1997 to 2005. METHODS: A cohort study was implemented using data for 407 family practices in the UK General Practice Research Database, including subjects with first acute strokes between 1997 and 2005. One-year case-fatality was estimated by year and sex. Rate ratios were estimated using Poisson regression. RESULTS: There were 19 143 women and 16 552 men who had first acute strokes between 1997 and 2005. In women, the 1-year case-fatality declined from 41.2% in 1997 to 29.2% in 2005. In men, the decline was from 29.2% in 1997 to 22.2% in 2005. The proportion of general practices that prescribed antihypertensive drugs to two-thirds or more of new patients with stroke increased from 6% in 1997 to 48% in 2005, for statins from 1% to 39% and for antiplatelet drugs from 11% to 39%. The rate ratio for 1-year mortality in 2005, compared with 1997-1998, adjusted for age group, sex, prevalent coronary heart disease, prevalent hypertension and deprivation quintile was 0.79 (0.74 to 0.86, p\textless0.001). After adjustment for antihypertensive, statin and antiplatelet prescribing, the rate ratio was 1.29 (1.17 to 1.42). CONCLUSIONS: Reducing 1-year case-fatality after acute stroke may be partly explained by increased prescribing of antihypertensive, statin and antiplatelet drugs to patients with recent strokes. However, these analyses did not include measures of possible changes over time in stroke severity or acute stroke management.
@article{gulliford_declining_2010,
	title = {Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management: population-based cohort study},
	volume = {81},
	issn = {1468-330X},
	shorttitle = {Declining 1-year case-fatality of stroke and increasing coverage of vascular risk management},
	doi = {10.1136/jnnp.2009.193136},
	abstract = {BACKGROUND: The authors estimated trends in 1-year case-fatality of stroke in relation to changes in vascular risk management from 1997 to 2005.
METHODS: A cohort study was implemented using data for 407 family practices in the UK General Practice Research Database, including subjects with first acute strokes between 1997 and 2005. One-year case-fatality was estimated by year and sex. Rate ratios were estimated using Poisson regression.
RESULTS: There were 19 143 women and 16 552 men who had first acute strokes between 1997 and 2005. In women, the 1-year case-fatality declined from 41.2\% in 1997 to 29.2\% in 2005. In men, the decline was from 29.2\% in 1997 to 22.2\% in 2005. The proportion of general practices that prescribed antihypertensive drugs to two-thirds or more of new patients with stroke increased from 6\% in 1997 to 48\% in 2005, for statins from 1\% to 39\% and for antiplatelet drugs from 11\% to 39\%. The rate ratio for 1-year mortality in 2005, compared with 1997-1998, adjusted for age group, sex, prevalent coronary heart disease, prevalent hypertension and deprivation quintile was 0.79 (0.74 to 0.86, p{\textless}0.001). After adjustment for antihypertensive, statin and antiplatelet prescribing, the rate ratio was 1.29 (1.17 to 1.42).
CONCLUSIONS: Reducing 1-year case-fatality after acute stroke may be partly explained by increased prescribing of antihypertensive, statin and antiplatelet drugs to patients with recent strokes. However, these analyses did not include measures of possible changes over time in stroke severity or acute stroke management.},
	language = {eng},
	number = {4},
	journal = {Journal of Neurology, Neurosurgery, and Psychiatry},
	author = {Gulliford, Martin C. and Charlton, Judith and Rudd, Anthony and Wolfe, Charles D. and Toschke, André Michael},
	month = apr,
	year = {2010},
	pmid = {20176596},
	pmcid = {PMC2921278},
	keywords = {Antihypertensive Agents, Cerebrovascular Disorders, Cohort Studies, Drug Prescriptions, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hypertension, Male, Platelet Aggregation Inhibitors, Population Surveillance, Risk Factors, Risk Reduction Behavior, Survival Rate, stroke},
	pages = {416--422}
}

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