[An estimation of the incidence of cerebrovascular accidents in France].

In the absence of epidemiological data concerning France, indirect assessment was undertaken of the incidence and prevalence of cerebrovascular accidents (CVA) at a national level. An international comparison of mortality data concerning diseases of the circulatory system was first made. This analysis reviewed the existence of a certain number of inherent difficulties in the use of available statistics. It is probable that a notable proportion, increasing with age, of cases of CVA, are situated in undefined causes. A similar phenomenon should be noted with regard to cardiac causes (changes in diagnostic practice in the case of ischemic heart disease). Furthermore, mortality data for CVA are very sensitive to the effect of the age and sex structures of the populations considered. Between the years 50 and 80, the absolute number of annual deaths by CVA roughly rose from 60 000 to 70 000 in France. However, after adjustment taking into account changes in numbers, age and sex and undetermined causes, there is a marked decrease in comparative levels (almost 40%). This decrease is of the same order of magnitude as that for mortality of circulatory system diseases taken overall, as well as that of general mortality. CVA remains the 3rd cause of death (in terms of numbers) but it is only in 8th place, in terms of loss of life expectancy. Taking as the reference the American National Survey of Stroke, using a certain number of hypotheses, it is possible to estimate the incidence of CVA in France. This gives an annual number of cases of the order of 140 000, including approximately 100 000 cases of initial CVA. The corresponding prevalence is estimated at 470 000 (mean numbers of individuals suffering one or more CVA).