Increase in stroke deaths after 1997 in the Czech Republic

Yearly mortality data on stroke in the Czech Republic, recorded from 1950 to 1999, were analysed. About 50- and 21-year cycles were suggested, regardless of whether all data were considered or whether they were analysed for men and women separately. After detrending, a self-starting cumulative sum (CUSUM) control chart showed an increase in stroke deaths that took place around 1997. These results are in keeping with similar findings in four other geographic locations. They warrant a renewed effort toward stroke prevention. Ambulatory monitoring of blood pressure and heart rate in the general population is a useful tool to detect and correct certain abnormalities of the circadian pattern of these variables which have been associated with large increases in stroke risk, even in conventionally normotensive subjects.