Decline in Regional Trends in Mortality of Stroke Subtypes in Germany From 1998 to 2015

Background and Purpose— Data on recent time trends in stroke mortality by subtypes and regions are lacking for Germany. We investigated sex- and age-standardized trends in stroke mortality in Germany for different stroke subtypes from 1998 to 2015 and assessed potential regional variations between the former Eastern and former Western part of Germany. Methods— Mortality and population data from the German Federal Statistical Office were used to calculate sex- and age-standardized mortality rates for hemorrhagic stroke, ischemic stroke, and total strokes from 1998 to 2015 for all age groups. Joinpoint regression was used to examine trends and its changes. Estimations were stratified for Eastern and Western part of Germany. Results— From 1998 to 2015, age-standardized total stroke mortality decreased by >50% in men (from 78.0 to 34.1 per 100 000) and women (from 62.1 to 28.4 women per 100 000). The decrease was more pronounced for ischemic stroke mortality (rate change: men, −66%; women, −63%) than for hemo...