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Effect of seasonal variation on the frequency of incident stroke hospitalizations in Scotland

Background: Strokes, like many other chronic diseases has a complex multi-factorial etiology. Factors like genetics, familial history, age, sex, ethnicity and race are all non-modifiable risk factors, whereas smoking, drinking, physical activity and diet can be modified to reduce the risk of stroke significantly. Aims: The aim of the present study was to see the association between seasonal variation and incidence of stroke in Scotland. Materials and Methods: Stroke data was obtained as SMR01 (1957, 639 incident stroke hospitalizations in Scotland between 1986-2005); from Information Service Division unit of National Health Service, Scotland and weather data from the United Kingdom Metrology Office. Using Chi square goodness of fit test, monthly as well as seasonal variations in the frequency of incidents strokes and its subtypes was evaluated after merging these data sets together. Result: In a total of 157,639 incident stroke hospitalizations between 1986-2005 in Scotland, overall incident strokes show statistically significant seasonal variations (P < 0.001, highest: Winter 26% and lowest: Summer 23.9%). Depending upon stroke sub-types, seasonal variation was found in incident strokes frequencies for intracerebral haemorrhage (winter: 26.2%; summer: 23.7%) ischaemic stroke (spring: 25.5%; summer 24.2%) and non-specific (winter: 26.4%; summer 23.7%). We failed to demonstrate any seasonal variations for subarachnoid haemorrhage. Conclusion: Winter predisposition seems to be multifactorial, i. e., respiratory infection and increased serum concentrations of plasma fibrinogen, total cholesterol, C-reactive proteins and aldosterone.