The incidence of stroke and transient ischaemic attacks is falling: a report from the Belgian sentinel stations

Increasing as well as decreasing trends in stroke incidence have been described. To examine time trends associated with the incidence of stroke and transient ischaemic attacks (TIAs) within an ongoing registration network. Analysis of data from a network of sentinel practices. Sentinel practice population (approximately 1.4% of the total Belgian population. Attack incidence rates of both stroke and TIA were studied at four one-year registration periods between 1984 and 1999. The number of events identified as stroke was 1097 (513 in males and 584 in females). The percentage of first-ever stroke was 69%, 64%, and 70% in 1989, 1998, and 1999 respectively. The number of events identified as TIAs was 382 (165 in males and 217 in females). The percentage of first-ever TIA was 65%, 69%, and 75% in 1989, 1998, and 1999 respectively. Yearly age-standardised attack rates of stroke significantly decreased during the registration period from 2.86 per 1000 in 1984, to 1.62 per 1000 in 1999 (chi2 for trend, P = 0.04) in males and from 2.97 per 1000 to 1.96 per 1000 (P = 0.007) for females. The decrease was restricted to subjects aged over 60 years. For TIA, a significant decrease (P = 0.014) was identified in females, but not in males (P = 0.61). Crude attack rates of stroke also significantly decreased, with an overall decrease between 1984 and 1999 of 37% in males and 26% in females. No such trend was found for TIA (P = 0. 63 for males and P = 0.35 for females). Both crude and age-standardised attack rates of stroke show a clear and significant decrease between 1984 and 1999. For TIA, a weaker trend was identified.