Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016
Journal article, 2018

BACKGROUND The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases. METHODS We used the Global Burden of Disease (GBD) Study 2016 estimates of stroke incidence and the competing risks of death from any cause other than stroke to calculate the cumulative lifetime risks of first stroke, ischemic stroke, or hemorrhagic stroke among adults 25 years of age or older. Estimates of the lifetime risks in the years 1990 and 2016 were compared. Countries were categorized into quintiles of the sociodemographic index (SDI) used in the GBD Study, and the risks were compared across quintiles. Comparisons were made with the use of point estimates and uncertainty intervals representing the 2.5th and 97.5th percentiles around the estimate. RESULTS The estimated global lifetime risk of stroke from the age of 25 years onward was 24.9% (95% uncertainty interval, 23.5 to 26.2); the risk among men was 24.7% (95% uncertainty interval, 23.3 to 26.0), and the risk among women was 25.1% (95% uncertainty interval, 23.7 to 26.5). The risk of ischemic stroke was 18.3%, and the risk of hemorrhagic stroke was 8.2%. In high-SDI, high-middle-SDI, and low- SDI countries, the estimated lifetime risk of stroke was 23.5%, 31.1% (highest risk), and 13.2% (lowest risk), respectively; the 95% uncertainty intervals did not overlap between these categories. The highest estimated lifetime risks of stroke according to GBD region were in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk was in eastern sub-Saharan Africa (11.8%). The mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% uncertainty interval, 6.2 to 11.5); the competing risk of death from any cause other than stroke was considered in this calculation. CONCLUSIONS In 2016, the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. There was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe.

Author

Gregory A. Roth

University of Washington

Valery L. Feigin

Grant Nguyen

Kelly Cercy

Catherine O. Johnson

Tahiya Alam

Priyakumari G. Parmar

Amanuel A. Abajobir

Kalkidan Hassen Abate

Foad Abd-Allah

Ayenew Negesse Abejie

Gebre Y. Abyu

Zanfina Ademi

Gina Agarwal

Muktar Beshir Ahmed

Rufus Olusola Akinyemi

Rajaa Al-Raddadi

Leopold N. Aminde

Catherine Amlie-Lefond

Hossein Ansari

Hamid Asayesh

Solomon Weldegebreal Asgedom

Tesfay M. Atey

Henok Tadesse Ayele

Maciej Banach

Amitava Banerjee

Aleksandra Barac

Suzanne L. Barker-Collo

Till Bärnighausen

Lars Barregård

Sanjay Basu

Neeraj Bedi

Masoud Behzadifar

Yannick Béjot

Derrick A. Bennett

Isabela M. Bensenor

Derbew Fikadu Berhe

Dube J. Boneya

Michael Brainin

Ismael Ricardo Campos-Nonato

Valeria Caso

Carlos A. Castañeda-Orjuela

Jacqueline Castillo Rivas

Ferrán Catalá-López

Hanne Christensen

Michael H. Criqui

Albertino Damasceno

Lalit Dandona

Rakhi Dandona

Kairat Davletov

Barbora de Courten

Gabrielle Aline Deveber

Klara Dokova

Dumessa Edessa

Matthias Endres

Emerito Jose Aquino Faraon

Maryam S. Farvid

Florian Fischer

Kyle Foreman

Mohammad H. Forouzanfar

Seana Gall

Tsegaye T. Gebrehiwot

Johanna M. Geleijnse

Richard F Gillum

Maurice Giroud

Alessandra Carvalho Goulart

Rahul Gupta

Rajeev Gupta

Vladimir Hachinski

Randah Ribhi Hamadeh

Graeme J. Hankey

Habtamu A. Hareri

Rasmus Havmoeller

Simon I. Hay

Mohamed I. Hegazy

Desalegn Tsegaw Hibstu

Spencer L. James

Panniyammakal Jeemon

Denny John

Jost B. Jonas

Jacek Józwiak

Rizwan Kalani

Amit Kandel

Amir Kasaeian

Andre Pascal Kengne

Yousef Saleh Khader

Abdur R. Khan

Young-Ho Khang

Jagdish Khubchandani

Daniel Kim

Yun J. Kim

Mika Kivimaki

Yoshihiro Kokubo

Dhaval Kolte

Jacek A. Kopec

Soewarta Kosen

Michael Kravchenko

Rita Krishnamurthi

G. Anil Kumar

Alessandra Lafranconi

Pablo M. Lavados

Yirga Legesse

Yongmei Li

Xiaofeng Liang

Warren D. Lo

Stefan Lorkowski

Paulo A. Lotufo

Clement T. Loy

Mark T. Mackay

Hassan Magdy Abd El Razek

Mahdi Mahdavi

Azeem Majeed

Reza Malekzadeh

Deborah Carvalho Malta

Abdullah A. Mamun

Lorenzo G. Mantovani

Sheila Cristina Ouriques Martins

Kedar K. Mate

Mohsen Mazidi

Chalmers, Biology and Biological Engineering, Food and Nutrition Science

Suresh Mehata

Toni Meier

Yohannes A Melaku

Walter Mendoza

George A. Mensah

Atte Meretoja

Haftay B. Mezgebe

Tomasz Miazgowski

Ted R. Miller

Norlinah M. Ibrahim

Shafiu Mohammed

Ali H. Mokdad

Mahmood Moosazadeh

Andrew E. Moran

Kamarul Imran Musa

Ruxandra Irina Negoi

Minh Nguyen

Quyen L. Nguyen

Trang Huyen Nguyen

Tung Thanh Tran

Thanh T. Nguyen

Dina Nur Anggraini Ningrum

Bo Norrving

Jean Jacques N. Noubiap

Martin J. O'Donnell

Andrew Toyin Olagunju

Oyere K. Onuma

Mayowa Ojo Owolabi

Mahboubeh Parsaeian

George C. Patton

Michael A. Piradov

Martin Pletcher

Farshad Pourmalek

V. Prakash

Mostafa Qorbani

Mahfuzar Rahman

Muhammad Aziz Rahman

Rajesh K. Rai

Annemarei Ranta

David Rawaf

Salman Rawaf

Andre M.N. Renzaho

Stephen R. Robinson

Ramesh Sahathevan

Amirhossein Sahebkar

Joshua A. Salomon

Paola Santalucia

Itamar S. Santos

Benn Sartorius

Aletta E. Schutte

Sadaf G. Sepanlou

Azadeh Shafieesabet

Masood Ali Shaikh

Morteza Shamsizadeh

Kevin N. Sheth

Mekonnen Sisay

Min-Jeong Shin

Ivy Shiue

Diego Augusto Santos Silva

Eugene Sobngwi

Michael Soljak

Reed J.D. Sorensen

Luciano A. Sposato

Saverio Stranges

Rizwan A. Suliankatchi

Rafael Tabarés-Seisdedos

David Tanne

Cuong Tat Nguyen

J.S. Thakur

Amanda G. Thrift

David L. Tirschwell

Roman Topor-Madry

Bach Xuan Tran

Luong T. Nguyen

Thomas Truelsen

Nikolaos Tsilimparis

Stefanos Tyrovolas

Kingsley Nnanna Ukwaja

Olalekan A. Uthman

Yuri Varakin

Tommi Vasankari

Narayanaswamy Venketasubramanian

Vasiliy V. Vlassov

Wenzhi Wang

Andrea Werdecker

Charles D.A. Wolfe

Gelin Xu

Yuichiro Yano

Naohiro Yonemoto

Chuanhua Yu

Zoubida Zaidi

Maysaa El Sayed Zaki

Maigeng Zhou

Boback Ziaeian

Ben Zipkin

Theo Vos

Mohsen Naghavi

Christopher J.L. Murray

New England Journal of Medicine

0028-4793 (ISSN) 1533-4406 (eISSN)

Vol. 379 25 2429-2437

Subject Categories

Clinical Medicine

DOI

10.1056/NEJMoa1804492

PubMed

30575491

More information

Latest update

3/17/2021