Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016
Date
2018Author
Feigin, Valery L.
Schutte, Aletta E.
Nguyen, Grant
Cercy, Kelly
Johnson, Catherine O.
Metadata
Show full item recordAbstract
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 lowSDI 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
URI
http://hdl.handle.net/10394/32913https://www.nejm.org/doi/pdf/10.1056/NEJMoa1804492?articleTools=true
https://doi.org/10.1056/NEJMoa1804492
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247346/
Collections
- Faculty of Health Sciences [2386]