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Global burden of stroke in 2010: a pooling analysis of worldwide population-based data on stroke incidence

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Abstract

Aim

Stroke remains one of the most devastating conditions of all neurological diseases. Reliable information about its prevalence worldwide is essential to the development of national policies for the prevention and control of this condition.

Subjects and methods

We conducted a systematic review of the literature on the incidence of first-ever stroke and searched for population-based studies published between 1990 and 2013. Stroke incidence was analyzed by country income: high-income countries (HICs) and low- to middle-income countries (LMICs). We used epidemiological modeling to define age- and sex-specific incidence rates in the two country income groups together with 2010 United Nations population sizes to estimate the global incidence of stroke.

Results

Forty-two studies met the inclusion criteria (26,672,101 participants; 74,840 patients). In HICs, the incidence at age 45–49 years was 44.98 (40.75–49.65) for males and 46.52 (42.39–51.05) for females, and at age 85–89 years, it was 2,215.02 (1,919.53–2,554.82) for males and 1,620.37 (1,416.65–1,852.83) for females. The stroke incidence for both males and females was higher in LMICs than in HICs at age 45–49 years (69.63 [57.99–83.60] and 58.84 [49.63–69.76], respectively). Furthermore, it was higher in LMICs than HICs at age 85–89 years (2,777.58 [2,035.20–3,780.31] and 2,311.43 [1,752.27–3,043.48], respectively). Globally, more than 6 million people experienced first-stroke events in 2010, with 70.57 % of sufferers living in LMICs.

Conclusion

Stroke is a significant public health burden worldwide. The prevention, detection, treatment, and control of this condition should be a top priority.

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References

  • Abdul-Ghaffar N, El-Sonbaty M, el-Din Abdul-Baky M, Marafie A, Al-Said A (1997) Stroke in Kuwait: a three-year prospective study. Neuroepidemiology 16:40–47

    Article  CAS  PubMed  Google Scholar 

  • Ahmed M, Prakash PS, Hassan KM (1995) Stroke: incidence and pattern in Benghazi, Libya. Ann Saudi Med 15:367

    PubMed  Google Scholar 

  • Al-Rajeh S, Larbi EB, Bademosi O, Awada A, Yousef A, Al-Freihi H, Miniawi H (1998) Stroke register: experience from the eastern province of Saudi Arabia. Cerebrovasc Dis 8:86–89

    Article  CAS  PubMed  Google Scholar 

  • Appelros P, Nydevik I, Seiger Å, Terént A (2002) High incidence rates of stroke in Örebro, Sweden: Further support for regional incidence differences within Scandinavia. Cerebrovasc Dis 14:161–168

    Article  PubMed  Google Scholar 

  • Azarpazhooh MR, Etemadi MM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M, Ghandehary K, Farzadfard MT, Kiani R, Panahandeh M, Thrift AG (2010) Excessive incidence of stroke in Iran: evidence from the Mashhad Stroke Incidence Study (MSIS), a population-based study of stroke in the Middle East. Stroke 41:e3–e10. doi:10.1161/STROKEAHA.109.559708

    Article  PubMed  Google Scholar 

  • Bank TW Data (2012) Country and lending groups. http://data.worldbank.org/about/country-classifications/country-and-lendinggroups. Accessed accessed 15 October 2012

  • Bejot Y, Osseby GV, Aboa-Eboule C, Durier J, Lorgis L, Cottin Y, Moreau T, Giroud M (2009) Dijon’s vanishing lead with regard to low incidence of stroke. Eur J Neurol 16:324–329. doi:10.1111/j.1468-1331.2008.02415.x

    Article  CAS  PubMed  Google Scholar 

  • Brown R, Whisnant JP, Sicks J, O’Fallon WM, Wiebers DO (1996) Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke 27:373–380

    CAS  PubMed  Google Scholar 

  • Corbin DO, Poddar V, Hennis A, Gaskin A, Rambarat C, Wilks R, Wolfe CD, Fraser HS (2004) Incidence and case fatality rates of first-ever stroke in a black Caribbean population: the Barbados Register of Strokes. Stroke 35:1254–1258. doi:10.1161/01.STR.0000127371.24658.df

    Article  PubMed  Google Scholar 

  • Correia M, Silva MR, Matos I, Magalhaes R, Lopes JC, Ferro JM, Silva MC (2004) Prospective community-based study of stroke in Northern Portugal: incidence and case fatality in rural and urban populations. Stroke 35:2048–2053. doi:10.1161/01.STR.0000137606.34301.13

    Article  PubMed  Google Scholar 

  • Di Carlo A, Inzitari D, Galati F, Baldereschi M, Giunta V, Grillo G, Furch A, Manno V, Naso F, Vecchio A, Consoli D (2003) A Prospective Community-Based Study of Stroke in Southern Italy: The Vibo Valentia Incidence of Stroke Study (VISS). Cerebrovasc Dis 16:410–417. doi:10.1159/000072565

    Article  PubMed  Google Scholar 

  • Diaz-Guzman J, Egido JA, Gabriel-Sanchez R, Barbera-Comes G, Fuentes-Gimeno B, Fernandez-Perez C, Group ISIotSPotSCDS (2012) Stroke and transient ischemic attack incidence rate in Spain: the IBERICTUS study. Cerebrovasc Dis 34:272–281. doi:10.1159/000342652

    Article  PubMed  Google Scholar 

  • Dong Z (2002) A population-based study of stroke incidence and mortality in China. Chin J Epidemiol 23:49–53

    Google Scholar 

  • Ellekjaer H, Holmen J, Indredavik B, Terent A (1997) Epidemiology of stroke in Innherred, Norway, 1994 to 1996. Incidence and 30-day case-fatality rate. Stroke 28:2180–2184

    Article  CAS  PubMed  Google Scholar 

  • Feigin VL, Wiebers DO, Whisnant JP, O’Fallon WM (1995) Stroke incidence and 30-day case-fatality rates in Novosibirsk, Russia, 1982 through 1992. Stroke 26:924–929

    Article  CAS  PubMed  Google Scholar 

  • Feigin V, Carter K, Hackett M, Barber PA, McNaughton H, Dyall L, Chen M, Anderson C (2006) Ethnic disparities in incidence of stroke subtypes: Auckland Regional Community Stroke Study, 2002–2003. Lancet Neurol 5:130–139. doi:10.1016/s1474-4422(05)70325-2

    Article  PubMed  Google Scholar 

  • Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V (2009) Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 8:355–369. doi:10.1016/S1474-4422(09)70025-0

    Article  PubMed  Google Scholar 

  • Fowkes FGR, Rudan D, Rudan L, Aboyans V, Denenberg JO, McDermott MM, Norman P, Sampson UK, Williams LJ, Mensah GA, Criqui MH (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 382:1329–1340. doi:10.1016/s0140-6736(13)61249-0

    Article  PubMed  Google Scholar 

  • Hamad A, Hamad A, Sokrab TE, Momeni S, Mesraoua B, Lingren A (2001) Stroke in Qatar: a one-year, hospital-based study. J Stroke Cerebrovasc Dis 10:236–241. doi:10.1053/jscd.2001.30382

    Article  CAS  PubMed  Google Scholar 

  • Hatano S (1976) Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ 54:541

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hilmarsson A, Kjartansson O, Olafsson E (2013) Incidence of first stroke: a population study in Iceland. Stroke 44:1714–1716. doi:10.1161/STROKEAHA.111.000222

    Article  CAS  PubMed  Google Scholar 

  • Hollander M, Koudstaal P, Bots M, Grobbee D, Hofman A, Breteler M (2003) Incidence, risk, and case fatality of first ever stroke in the elderly population. The Rotterdam Study. J Neurol Neurosurg Psychiatry 74:317–321

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Iemolo F, Beghi E, Cavestro C, Micheli A, Giordano A, Caggia E (2002) Incidence, risk factors and short-term mortality of stroke in Vittoria, southern Italy. Neurol Sci 23:15–21

    Article  CAS  PubMed  Google Scholar 

  • Intiso D, Stampatore P, Zarrelli MM, Guerra GL, Arpaia G, Simone P, Tonali P, Beghi E (2003) Incidence of first-ever ischemic and hemorrhagic stroke in a well-defined community of southern Italy, 1993–1995. Eur J Neurol 10:559–565

    Article  CAS  PubMed  Google Scholar 

  • Ishikawa S, Kayaba K, Gotoh T, Nago N, Nakamura Y, Tsutsumi A, Kajii E (2008) Incidence of Total Stroke, Stroke Subtypes, and Myocardial Infarction in the Japanese Population: The JMS Cohort Study. J Epidemiol 18:144–150. doi:10.2188/jea.JE2007438

    Article  PubMed  PubMed Central  Google Scholar 

  • Johansen HL, Wielgosz AT, Nguyen K, Fry RN (2006) Incidence, comorbidity, case fatality and readmission of hospitalized stroke patients in Canada. Can J Cardiol 22:65–71

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnston SC, Mendis S, Mathers CD (2009) Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol 8:345–354

    Article  PubMed  Google Scholar 

  • Jorgensen HS, Plesner AM, Hubbe P, Larsen K (1992) Marked increase of stroke incidence in men between 1972 and 1990 in Frederiksberg, Denmark. Stroke 23:1701–1704. doi:10.1161/01.str.23.12.1701

    Article  CAS  PubMed  Google Scholar 

  • Kulesh SD, Filina NA, Frantava NM, Zhytko NL, Kastsinevich TM, Kliatskova LA, Shumskas MS, Hilz MJ, Schwab S, Kolominsky-Rabas PL (2010) Incidence and case-fatality of stroke on the East border of the European union: The Grodno Stroke Study. Stroke 41:2726–2730. doi:10.1161/STROKEAHA.110.596916

    Article  PubMed  Google Scholar 

  • Lavados PM, Sacks C, Prina L, Escobar A, Tossi C, Araya F, Feuerhake W, Galvez M, Salinas R, Alvarez G (2005) Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project). Lancet 365:2206–2215. doi:10.1016/s0140-6736(05)66779-7

    Article  PubMed  Google Scholar 

  • Lopez AD, Mathers CD (2006) Measuring the global burden of disease and epidemiological transitions: 2002–2030. Ann Trop Med Parasitol 100:481–499. doi:10.1179/136485906x97417

    Article  CAS  PubMed  Google Scholar 

  • Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006a) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367:1747–1757. doi:10.1016/s0140-6736(06)68770-9

    Article  PubMed  Google Scholar 

  • Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006b) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367:1747–1757

    Article  PubMed  Google Scholar 

  • Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2095–2128. doi:10.1016/s0140-6736(12)61728-0

    Article  PubMed  Google Scholar 

  • Matenga J (1997) Stroke incidence rates among black residents of Harare—a prospective community-based study. S Afr Med J 87:606–608

    CAS  PubMed  Google Scholar 

  • Medin J, Nordlund A, Ekberg K (2004) Increasing stroke incidence in Sweden between 1989 and 2000 among persons aged 30 to 65 years: evidence from the Swedish Hospital Discharge Register. Stroke 35:1047–1051

    Article  CAS  PubMed  Google Scholar 

  • Meyer K, Simmet A, Arnold M, Mattle H, Nedeltchev K (2009) Stroke events and case fatalities in Switzerland based on hospital statistics and cause of death statistics. Swiss Med Wkly 139:65

    CAS  PubMed  Google Scholar 

  • Mihalka L, Smolanka V, Bulecza B, Mulesa S, Bereczki D (2001) A Population Study of Stroke in West Ukraine: Incidence, Stroke Services, and 30-Day Case Fatality. Stroke 32:2227–2231. doi:10.1161/hs1001.097107

    Article  CAS  PubMed  Google Scholar 

  • Minelli C, Fen LF, Minelli DP (2007) Stroke incidence, prognosis, 30-day, and 1-year case fatality rates in Matao, Brazil: a population-based prospective study. Stroke 38:2906–2911. doi:10.1161/STROKEAHA.107.484139

    Article  PubMed  Google Scholar 

  • Mirzaei M, Truswell AS, Arnett K, Page A, Taylor R, Leeder SR (2012) Cerebrovascular disease in 48 countries: secular trends in mortality 1950–2005. J Neurol Neurosurg Psychiatry 83:138–145

    Article  PubMed  Google Scholar 

  • Mukherjee D, Patil CG (2011) Epidemiology and the global burden of stroke. World Neurosurg 76:S85–90. doi:10.1016/j.wneu.2011.07.023

    Article  PubMed  Google Scholar 

  • Musolino R, La Spina P, Serra S, Postorino P, Calabro S, Savica R, Salemi G, Gallitto G (2005) First-ever stroke incidence and 30-day case fatality in the Sicilian Aeolian archipelago, Italy. Stroke 36:2738–2741. doi:10.1161/01.STR.0000190907.88846.df

    Article  PubMed  Google Scholar 

  • Nations U (2011) World Population Prospects, the 2010 Revision. http://esa.un.org/unpd/wpp/Excel-Data/mortality.htm. Accessed accessed 30 June 2012

  • Numminen H, Kotila M, Waltimo O, Aho K, Kaste M (1996) Declining incidence and mortality rates of stroke in Finland from 1972 to 1991. Results of three population-based stroke registers. Stroke 27:1487–1491

    Article  CAS  PubMed  Google Scholar 

  • Palm F, Urbanek C, Rose S, Buggle F, Bode B, Hennerici MG, Schmieder K, Inselmann G, Reiter R, Fleischer R, Piplack KO, Safer A, Becher H, Grau AJ (2010) Stroke incidence and survival in Ludwigshafen am Rhein, Germany: the Ludwigshafen Stroke Study (LuSSt). Stroke 41:1865–1870. doi:10.1161/STROKEAHA.110.592642

    Article  PubMed  Google Scholar 

  • Powles J, Kirov P, Feschieva N, Stanoev M, Atanasova V (2002) Stroke in urban and rural populations in north-east Bulgaria: incidence and case fatality findings from a ‘hot pursuit’ study. BMC Public Health 2:24

    Article  PubMed  PubMed Central  Google Scholar 

  • Rastenyte D, Cepaitis Z, Sarti C, Bluzhas J, Tuomilehto J (1995) Epidemiology of Stroke in Kaunas, Lithuania. First results from the Kaunas Stroke Register. Stroke 26:240–244

  • Redon J, Olsen MH, Cooper RS, Zurriaga O, Martinez-Beneito MA, Laurent S, Cifkova R, Coca A, Mancia G (2011) Stroke mortality and trends from 1990 to 2006 in 39 countries from Europe and Central Asia: implications for control of high blood pressure. Eur Heart J:ehr045

  • Ricci S, Celani MG, La Rosa F, Vitali R, Duca E, Ferraguzzi R, Paolotti M, Seppoloni D, Caputo N, Chiurulla C (1991) SEPIVAC: a community-based study of stroke incidence in Umbria, Italy. J Neurol Neurosurg Psychiatry 54:695–698

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rothwell PM, Coull AJ, Giles MF, Howard SC, Silver LE, Bull LM, Gutnikov SA, Edwards P, Mant D, Sackley CM, Farmer A, Sandercock PAG, Dennis MS, Warlow CP, Bamford JM, Anslow P (2004) Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 363:1925–1933. doi:10.1016/s0140-6736(04)16405-2

    Article  CAS  PubMed  Google Scholar 

  • Rozenthul-Sorokin N, Ronen R, Tamir A, Geva H, Eldar R (1996) Stroke in the young in Israel. Incidence and outcomes. Stroke 27:838–841

    Article  CAS  PubMed  Google Scholar 

  • Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J (2000) International trends in mortality from stroke, 1968 to 1994. Stroke 31:1588–1601

    Article  CAS  PubMed  Google Scholar 

  • Sienkiewicz-Jarosz H, Gluszkiewicz M, Pniewski J, Niewada M, Czlonkowska A, Wolfe C, Ryglewicz D (2011) Incidence and case fatality rates of first-ever stroke–comparison of data from two prospective population-based studies conducted in Warsaw. Neurol Neurochir Pol 45:207–212

    PubMed  Google Scholar 

  • Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, Radhakrishnan K (2009) Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum Stroke Registry. Stroke 40:1212–1218. doi:10.1161/STROKEAHA.108.531293

    Article  PubMed  Google Scholar 

  • Strong K, Mathers C, Bonita R (2007) Preventing stroke: saving lives around the world. Lancet Neurol 6:182–187. doi:10.1016/S1474-4422(07)70031-5

    Article  PubMed  Google Scholar 

  • Sudlow C, Warlow C (1996) Comparing stroke incidence worldwide what makes studies comparable? Stroke 27:550–558

    Article  CAS  PubMed  Google Scholar 

  • Thrift AG, Dewey HM, Macdonell RAL, McNeil JJ, Donnan GA (2000) Stroke Incidence on the East Coast of Australia: The North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 31:2087–2092. doi:10.1161/01.str.31.9.2087

    Article  CAS  PubMed  Google Scholar 

  • Towfighi A, Saver JL, Engelhardt R, Ovbiagele B (2007) A midlife stroke surge among women in the United States. Neurology 69:1898–1904

    Article  PubMed  Google Scholar 

  • Tsiskaridze A, Djibuti M, Van Melle G, Lomidze G, Apridonidze S, Gauarashvili I, Piechowski-Jozwiak B, Shakarishvili R, Bogousslavsky J (2004) Stroke incidence and 30-day case-fatality in a suburb of Tbilisi: results of the first prospective population-based study in Georgia. Stroke 35:2523–2528. doi:10.1161/01.STR.0000144683.96048.98

    Article  PubMed  Google Scholar 

  • Vemmos KN, Bots ML, Tsibouris PK, Zis VP, Grobbee DE, Stranjalis GS, Stamatelopoulos S (1999) Stroke incidence and case fatality in Southern Greece: The Arcadia Stroke Registry. Stroke 30:363–370. doi:10.1161/01.str.30.2.363

    Article  CAS  PubMed  Google Scholar 

  • Vibo R, Korv J, Roose M (2007) The Third Stroke Registry in Tartu, Estonia, from 2001 to 2003. Acta Neurol Scand 116:31–36. doi:10.1111/j.1600-0404.2006.00773.x

    Article  CAS  PubMed  Google Scholar 

  • Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2163–2196

    Article  PubMed  Google Scholar 

  • Wieberdink RG, Ikram MA, Hofman A, Koudstaal PJ, Breteler MM (2012) Trends in stroke incidence rates and stroke risk factors in Rotterdam, the Netherlands from 1990 to 2008. Eur J Epidemiol 27:287–295. doi:10.1007/s10654-012-9673-y

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organization (2008) WHO Burden of Disease Statistics. http://www.who.int/healthinfo/bod/en/index.html. Accessed accessed 2 May 2008

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  1. Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, People’s Republic of China

    Yuanyuan Li, Yue Wu & Weidong Zhang

  2. Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China

    Chengda Zhang

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  1. Yuanyuan Li
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Li, Y., Zhang, C., Wu, Y. et al. Global burden of stroke in 2010: a pooling analysis of worldwide population-based data on stroke incidence. J Public Health 24, 513–520 (2016). https://doi.org/10.1007/s10389-016-0748-1

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