Differences between coronary disease and stroke in incidence, case fatality, and risk factors, but few differences in risk factors for fatal and non-fatal events

doi:10.1093/eurheartj/ehi412

European Heart Journal Advance Access originally published online on July 11, 2005
European Heart Journal 2005 26(18):1916-1922; doi:10.1093/eurheartj/ehi412

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Differences between coronary disease and stroke in incidence, case fatality, and risk factors, but few differences in risk factors for fatal and non-fatal events

Lars Wilhelmsen¹^,*, Max Köster², Per Harmsen¹ and Georg Lappas¹

¹Section of Preventive Cardiology, The Cardiovascular Institute, Göteborg University, Drakegatan 6, SE-412 50 Göteborg, Sweden
²Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden

Received 15 February 2005; revised 2 June 2005; accepted 16 June 2005.

^* Corresponding author. Tel: +46 31 703 1884; fax: +46 31 703 1890. E-mail address: lars.wilhelmsen{at}scri.se

Aims To compare incidence and mortality of coronary and strokeevents, and risk factors for non-fatal and fatal events, respectively.

Methods and results Incidence and mortality were compared inall coronary (n=559 341) and stroke (n=530 689) eventsin Sweden from 1987 to 2001. Data from 28 years of follow-upof a random sample of 7400 men aged 47–55 and free ofdisease at baseline were used to compare risk factors. Incidenceand 28 days of case fatality were considerably higher for coronarydisease than for stroke, especially for men. Incidence of coronarydisease decreased, especially for men (P=0.0001 for both sexes),and mortality declined for both men and women during 1987–2001(P=0.0001 for both sexes). Stroke incidence declined slightly(P=0.0001 for both sexes), and there was a decline of mortality(P=0.0001 for both sexes). Out-of-hospital mortality duringthe first 28 days was higher than in-hospital mortality forcoronary events, whereas for stroke, in-hospital mortality washigher (in men) or the same (in women) as out-of-hospital mortality.High serum cholesterol was a strong risk factor for coronaryevents, but not for stroke. High blood pressure was a strongerrisk factor for stroke. About 50% of men with both stroke andcoronary disease died from coronary disease.

Conclusion Several differences regarding incidence, mortality,prognosis, and risk factors for stroke and coronary diseasepoint towards different pathologies.

Key Words: Coronary disease • Stroke • Incidence • Mortality • Risk factors • Pathology

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