Measuring changes in stroke incidence and outcome in Oxfordshire over 20 years

Stroke is a leading cause of death and disability, and has an enormous physical, emotional and economic impact on patients, families and society. Reliable and up-to-date information on the incidence and outcomes of stroke is essential to the planning of stroke services and preventative strategies. Yet there has only ever been one 'high quality' study of the incidence of stroke in the UK - the Oxfordshire Community Stroke Project (OCSP). Even though the study was performed twenty years ago, current resource plans are often still based on data from the OCSP. More up-to-date information is urgently required. The number of deaths due to stroke have fallen in the UK, and in most other developed countries, over the last two decades, but it is uncertain to what extent this is due to fewer people having strokes or better survival after stroke. The UK population has also aged over the last two decades, tending to increase the incidence of stroke.

The researchers propose to repeat the OCSP using the same methods and in the same population as the original study. This study would be unique in being the only detailed epidemiological investigation in the Northern Hemisphere of recent changes in incidence, death rates, and outcome of stroke in a large and well-defined urban population. Until now such data is only available for the small and highly selected rural population of Rochester, Minnesota, USA. The study will provide reliable and up-to-date information on the current burden of stroke, and changes in the UK over the last 20 years. This would allow the researchers to evaluate the success of the UK in preventing and treating stroke, and to plan future services.

Scientific Title: A population based study of the changes in incidents and outcome of stroke and TIA in Oxfordshire over 20 years.

Classification:
Prevention, Epidemiology

Publications:

Rothwell P, Warlow C. Timing of transient ischaemic attacks preceding ischaemic stroke. Neurology 2005; 64: 817-20.

Flossmann E, Schulz U, Rothwell P. Potential confounding by intermediate phenotypes in studies of the genetics of ischaemic stroke. Cerebrovascular Diseases 2005; 19: 1-10.

Lovett J, Coull A, Rothwell P. Early risk of recurrence by subtype of ischaemic stroke in population-based incidence studies. Neurology 2004; 62: 1-6.

Schulz U, Flossmann E, Rothwell P. Heritability of ischaemic stroke in relation to age, vascular risk factors, and subtypes of incident stroke in population-based studies. Stroke 2004; 35: 819-824.

Coull A, Silver L, Bull L, Giles M, Rothwell P. Direct assessment of completeness of ascertainment in a stroke incidence study. Stroke 2004; 35: 2041-5.

Coull A, Lovett J, Rothwell P. Early risk of stroke after a TIA or minor stroke in a population-based incidence study. BMJ 2004; 328: 326-328.

Rothwell P, Coull A, Giles M, Howard S, Silver L, Bull L, Gutnikov S, Edwards P, Mant D, Sackley C, Farmer A, Sandercock P, Dennis M, Warlow C, Bamford J, Anslow P. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 2004; 363:1925-33.
Press release on paper published in the Lancet 2004 showing that preventative measures against stroke can reduce incidence

Coull A, Rothwell P. Underestimation of the Early Risk of Recurrent Stroke: Evidence of the Need for a Standard Definition. Stroke 2004;35:1925-1929.

Flossmann E, Rothwell P. Prognosis of verterobrobasilar transient ischaemic attack and minor ischaemic stroke. Brain 2003; 126: 1940-54.

Schulz U, Rothwell P. Differences in vascular risk factors between aetiological subtypes of ischaemic stroke in population-based incidence studies. Stroke 2003; 34: 2050-59.

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