The epidemiology and management of cerebrovascular disease

Abstract

Cerebrovascular disease (stroke) is the third leading cause of death in New Zealand and an important cause of chronic disability. An analysis of routinely available national mortality data indicates that death rates have declined significantly since the 1950s and an acceleration of the rate of decline has occurred during the past decade. Reasons for the decline are unknown, although the most probable explanation is a decline in incidence rather than an improvement in case fatality rates. National data however provides little information about the total impact of the disease on a defined population. The Auckland Stroke study was developed to measure the incidence and natural history of the disease, to document the patterns of management, and to describe the range and duration of health services directed at those who survive the acute phase. An innovative sampling method was used to identify a 50% representative sample of all new stroke episodes (WHO criteria) occurring in residents of the Auckland region (total population 829,545) in a one year period; structured interviews were carried out at intervals throughout the year following the onset of the stroke.