Stroke prevalence in Taiwan - Findings from the 1994 National Health Interview Survey

Background and Purpose Stroke has been the second leading cause of death for all ages in Taiwan since 1983. However, despite the severity of the threat, stroke prevalence in Taiwan has not yet been addressed in a nationwide survey. In this study, the stroke prevalence in Taiwan was investigated using data from the 1994 National Health Interview Survey. Methods This nationwide survey sought to obtain a nationally representative sample of households in Taiwan by using three-stage stratified random sampling with a probability proportional to size. In the first stage, 58 townships were selected, from the 359 townships in Taiwan, according to their administrative structure and level of socioeconomic development. In the second stage, 149 basic administrative regions (tsun or ii) were selected from the selected 58 townships. Finally, 3814 households were selected from the 149 selected tsuns or lis. Field interviews were carried out between October 1994 and December 1994. Follow-up interviews with families of stroke patients were made 2 years later. Results Of the selected households 3119, or 81.8%, responded. A total of 11 925 persons were interviewed, and 71 of them were stroke patients, with a crude point prevalence rate of 5.95 per 1000. The stroke prevalence increased steadily with age, from 0.51 per 1000 in persons aged 35 to 44 years to 113.6 per 1000 in persons aged 85 years or over. There was a weak association with higher stroke prevalence for persons living in eastern Taiwan or those of lower educational level. The overall male/female prevalence ratio was 1.17. The results of follow-up interviews showed a cumulative mortality rate of 25.4% within the 2-year period and an ischemic/hemorrhagic stroke ratio of 1.33 in 35 patients whose stroke type could be validated. Conclusions Age was the most important factor correlating to stroke prevalence. On the basis of this result, planning policies and programs for stroke prevention in Taiwan should give a higher priority to (1) aggressive primary prevention for aged people who are apparently at higher risk of stroke and (2) early reduction of stroke risk factors in younger aged people whose immediate risk of stroke is lower but would increase significantly with age.