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RESEARCH PRODUCT

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

Feigin VNguyen GCercy KJohnson CAlam TParmar PAbajobir AAbate KAbd-allah FAbejie AAbyu GAdemi ZAgarwal GAhmed MAkinyemi RAl-raddadi RAminde LAmlie-lefond CAnsari HAsayesh HAsgedom SAtey TAyele HBanach MBanerjee ABarac ABarker-collo SBarnighausen TBarregard LBasu SBedi NBehzadifar MBejot YBennett DBensenor IBerhe DBoneya DBrainin MCampos-nonato ICaso VCastaneda-orjuela CRivas JCatala-lopez FHanne ChristensenCriqui MDamasceno ADandona LDandona RDavletov KDe Courten BDeveber GDokova KEdessa DEndres MFaraon EFarvid MFischer FForeman KForouzanfar MGall SGebrehiwot TGeleijnse JGillum RGiroud MGoulart AGupta RGupta RHachinski VHamadeh RHankey GHareri HHavmoeller RHay SHegazy MHibstu DJames SJeemon PJohn DJonas JJozwiak JKalani RKandel AKasaeian AKengne AKhader YKhan AKhang YKhubchandani JKim DKim YKivimaki MKokubo YKolte DKopec JKosen SKravchenko MKrishnamurthi RKumar GLafranconi ALavados PLegesse YLi YLiang XLo WLorkowski SLotufo PLoy CMackay MAbd El Razek HMahdavi MMajeed AMalekzadeh RMalta DMamun AMantovani LMartins SMate KMazidi MMehata SMeier TMelaku YMendoza WMensah GMeretoja AMezgebe HMiazgowski TMiller TIbrahim NMohammed SMokdad AMoosazadeh MMoran AMusa KNegoi RNguyen MNguyen QNguyen TTran TNguyen TNingrum DNorrving BNoubiap JO'donnell MOlagunju AOnuma OOwolabi MParsaeian MPatton GPiradov MPletcher MPourmalek FPrakash VQorbani MRahman MRahman MRai RRanta ARawaf DRawaf SRenzaho ARobinson SSahathevan RSahebkar ASalomon JSantalucia PSantos ISartorius BSchutte ASepanlou SShafieesabet AShaikh MShamsizadeh MSheth KSisay MShin MShiue ISilva DSobngwi ESoljak MSorensen RSposato LStranges SSuliankatchi RTabares-seisdedos RTanne DNguyen CThakur JThrift ATirschwell DTopor-madry RTran BNguyen LTruelsen TTsilimparis NTyrovolas SUkwaja KUthman OVarakin YVasankari TVenketasubramanian NVlassov VWang WWerdecker AWolfe CXu GYano YYonemoto NYu CZaidi ZZaki MZhou MZiaeian BZipkin BVos TNaghavi MMurray CRoth GGbd 2016 Lifetime Risk Stroke

subject

MalePercentileNutrition and DiseaseDisease030204 cardiovascular system & hematologyGlobal HealthSocioeconomic FactorGlobal Burden of Disease0302 clinical medicinepreventionVoeding en ZiekteCause of DeathGlobal healthStrokePOPULATIONCause of deathAged 80 and overeducation.field_of_studyIncidence (epidemiology)IncidenceMedicine (all)11 Medical And Health SciencesGeneral MedicineMiddle Agedlifetime riskstroke3142 Public health care science environmental and occupational health3. Good healthStrokeGBD 2016 Lifetime Risk of Stroke CollaboratorsFemaleBURDENLife Sciences & BiomedicineResearch ArticleHumanAdultRiskPopulationGlobal Burden of Disease (GBD)03 medical and health sciencesMedicine General & InternalAge DistributionGeneral & Internal MedicinemedicineHumansLife SciencePoint estimationcardiovascular diseasesSex DistributioneducationVLAGAgedScience & TechnologyHYPERTENSIONbusiness.industrymedicine.diseaseSocioeconomic Factorsbusiness030217 neurology & neurosurgeryRCDemography

description

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. (Funded by the Bill and Melinda Gates Foundation.)

10.1056/nejmoa1804492http://hdl.handle.net/10281/219011