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Cayuela A, Cayuela L, Ortega Belmonte MJ, et al. ¿Ha dejado de disminuir la mortalidad por enfermedades cerebrovasculares en España? Has stroke mortality stopped declining in Spain?. Neurologia (Engl Ed). 2019;doi: 10.1016/j.nrl.2019.06.001.
Cayuela, A., Cayuela, L., Ortega Belmonte, M. J., Rodríguez-Domínguez, S., Escudero-Martínez, I., & González, A. (2019). ¿Ha dejado de disminuir la mortalidad por enfermedades cerebrovasculares en España? Has stroke mortality stopped declining in Spain?. Neurologia (Barcelona, Spain), . https://doi.org/10.1016/j.nrl.2019.06.001
Cayuela, A, et al. "¿Ha dejado de disminuir la mortalidad por enfermedades cerebrovasculares en España?" Has stroke mortality stopped declining in Spain?. Neurologia (Barcelona, Spain) vol. (2019). doi: https://doi.org/10.1016/j.nrl.2019.06.001
Cayuela A, Cayuela L, Ortega Belmonte MJ, Rodríguez-Domínguez S, Escudero-Martínez I, González A. ¿Ha dejado de disminuir la mortalidad por enfermedades cerebrovasculares en España? Has stroke mortality stopped declining in Spain?. Neurologia (Engl Ed). 2019 Nov 25; doi: 10.1016/j.nrl.2019.06.001. Epub 2019 Nov 25. Spanish. PMID: 31780318.
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Neurologia (Engl Ed). 2019 Nov 25; doi: 10.1016/j.nrl.2019.06.001. Epub 2019 Nov 25.

Has stroke mortality stopped declining in Spain?.

Neurologia (Barcelona, Spain)

[Article in Spanish]
A Cayuela, L Cayuela, M J Ortega Belmonte, S Rodríguez-Domínguez, I Escudero-Martínez, A González

Affiliations

  1. Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España. Electronic address: [email protected].
  2. Departamento de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, España.
  3. Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España.
  4. Centro de Salud Pino Montano A, Distrito Sevilla, Sevilla, España.
  5. Unidad de Ictus, Unidad de Gestión Clínica de Neurociencias, Hospital Universitario Virgen del Rocío, Sevilla, España.
  6. Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, España.

PMID: 31780318 DOI: 10.1016/j.nrl.2019.06.001

Abstract

OBJECTIVES: To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models.

METHODS: Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend.

RESULTS: Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands.

CONCLUSIONS: Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.

Copyright © 2019 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Keywords: Cerebrovascular diseases; Enfermedades cerebrovasculares; Epidemiology; Epidemiología; Mortalidad; Mortality; Tendencias; Trends

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