Epidemiologische aspecten van cerebrovasculaire accidenten: een literatuurstudie over de periode 1980-1988
Epidemiologic aspects of cerebrovascular accidents: a literature survey on the period 1980-1988
RIVM Rapport 528909001
The results of a methodologic analysis of (trends in) incidence and mortality of cerebrovascular accidents (CVA, stroke), and risk factors for stroke are presented. Special attention has been paid to the design, analysis and comparability of the data and validity of the results. Countries differ widely in incidence and mortality of stroke. In the past three decades the incidence and mortality of non-hemorrhagic stroke and intracerebral hemorrhages have been decreasing mondially with 18-50%. Hypertension is the most important independent risk factor for all types of stroke. This has been confirmed results of clinical trials evaluating the effect of treatment of hypertension. Transient ischemic attacks and stenosis of the carotid artery increase the risk for stroke. Cardial disorders, smoking of cigarettes and diabetes mellitus are also risk factors for stroke. Alcohol consumption gives a greater risk for hemorrhagic stroke. Serum cholesterol appears to be inversely associated with the hemorrhagic types of stroke. Vitamine C and potassium are possibly protective against death from hemorrhagic resp. thrombo-embolic stroke. Clinical trials provide evidence that treatment of persons with aspirin who had one or more transient ischemic attachs (TIA) lowers the incidence and mortality from stroke.