Health Problems

Stroke incidence rising in Taiwan contrary to falls in Western countries

The incidence of stroke is rising in Taiwan contrary to falls in Western countries, according to a nationwide study presented at the ASEAN Federation of Cardiology Congress 2018 (AFCC 2018).

AFCC 2018 is being held 28 September to 1 October in Bangkok, Thailand. The meeting is hosted by The Heart Association of Thailand and organised by the ASEAN Federation of Cardiology. Visiting experts from the European Society of Cardiology (ESC) will present key messages from ESC guidelines.

Stroke is the third leading cause of death and most common cause of complex disability in Taiwan, a country of about 23 million people. The burden of stroke, particularly ischaemic stroke, is greater in East Asia compared to Western countries. Stroke occurrence has declined in several Western nations due to better management of risk factors, but much less is known about patterns in East Asia in the last decade.

This study examined the incidence of stroke over a 13-year period in Taiwan. For this nationwide cohort study, researchers reviewed the records of all hospitalised patients with a primary diagnosis of stroke between 2001 and 2013 from the Taiwan National Health Insurance Research Database.

They also recorded the type of stroke: ischaemic (caused by clots which cut off blood supply to parts of the brain), intracerebral haemorrhage (bleeding within the brain), and subarachnoid haemorrhage (bleeding on the surface of the brain).

A total of 23,023 first-ever strokes were identified. Of those, 66.9% were ischaemic stroke, 21.1% were intracerebral haemorrhage, 2.9% were subarachnoid haemorrhage, and 9.1% were of undetermined type.

After adjusting for the rising age of the population, the researchers found that the incidence of ischaemic stroke increased from 110 to 122 per 100,000 person-years, intracerebral haemorrhage increased from 30 to 38 per 100,000 person-years, and the rate of subarachnoid haemorrhage was stable.

Study author Dr. Yuan-Horng Yan, of Kuang Tien General Hospital, and associate professor of Hung Kuang University, Taichung, Taiwan, said: “Many strokes could be prevented with a healthy lifestyle, which includes not smoking, being physically active, eating healthily, keeping body weight down, and limiting alcohol consumption. Adopting behaviours that are good for you help to prevent high blood pressure, high cholesterol, and type 2 diabetes, which contribute to strokes. People who already have these conditions should consult their doctor about taking medication.”

Dr. Rungroj Krittayaphong, scientific chairperson of AFCC 2018, said: “Cardiovascular disease remains the major cause of death in Asian populations, particularly in ASEAN countries. Many previous reports have shown that strokes are more common in Asian than Western populations and the prevalence is increasing. We do not have data on the extent to which genetic factors contribute to the greater occurrence of stroke in Asian patients. Every effort should be made to develop regional strategies to explore the factors leading to stroke and establish management guidelines to tackle this issue.”

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