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Global lifetime stroke risk in 2016 similar by sex, varied by country
The global lifetime risk for stroke for men and women older than 25 years was 25% in 2016, according to a study published in The New England Journal of Medicine.
The risk for stroke varied by location, with the highest risk seen in Central Europe, East Asia and Eastern Europe, according to the study.
“Our findings are startling,” Gregory Roth, MD, MPH, assistant professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, said in a press release. “It is imperative that physicians warn their patients about preventing strokes and other vascular diseases at earlier points in patients’ lives. We found extremely high lifetime risk for stroke, and based on other research we evaluated, it is clear that younger adults need to think about long-term health risks. They can make a real difference by eating healthier diets, exercising regularly and avoiding tobacco and alcohol.”
Valery L. Feigin, MD, MSc, PhD, FAAN, director and professor of the National Institute for Stroke and Applied Neurosciences at Auckland University of Technology in New Zealand and affiliate professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, and colleagues analyzed data from Global Burden of Disease Study 2016 of participants aged at least 25 years. Information obtained from the study included rates of cause-specific mortality, first stroke and all-cause mortality at national, regional and global levels.
Countries included in this study were categorized by sociodemographic index: high, high-medium, medium, medium-low and low level of development. Researchers estimated lifetime risk for stroke by stroke prevalence, incidence and mortality rates by each 5-year age group.
The global lifetime risk for stroke in 2016 for participants starting at age 25 years was 24.9% (95% uncertainty interval, 23.5-26.2). The highest global lifetime risk for stroke was seen in East Asia (38.8%; 95% uncertainty interval, 37-40.6), followed by Central Europe (31.7%; 95% uncertainty interval, 30-33.3) and Eastern Europe (31.6%; 95% uncertainty interval, 27.6-35.6). The lowest stroke risk was seen in eastern sub-Saharan Africa (11.8%; 95% uncertainty interval, 10.9-12.8).
The greatest global lifetime risk for stroke was seen in countries that had a high-middle sociodemographic index (31.1%; 95% uncertainty interval, 29-33), followed by countries with middle sociodemographic index (29.3%; 95% uncertainty interval, 27.8-30.8) and low sociodemographic index (13.2%; 95% uncertainty interval, 12.3-14.2). High sociodemographic index countries had a risk for stroke of 23.5% (95% uncertainty interval, 22.2-24.8).
The risk for stroke was similar in men (24.7%; 95% uncertainty interval, 23.3-26) and women (25.1%; 95% uncertainty interval, 23.7-26.5).
The risk for ischemic stroke was 18.3% compared with 8.2% for the risk for hemorrhagic stroke.
Global lifetime risk estimates for stroke increased from 22.8% in 1990 to 24.9% in 2016. This represented a relative increase of 8.9% (95% uncertainty interval, 6.2-11.5).
“Knowledge of lifetime risk may be useful for stroke prevention and public education,” Feigin and colleagues wrote. “High estimates of lifetime risk of stroke suggest that there is possible value of measures for the primary prevention of stroke throughout a person’s life span and suggest that strategies to reduce cardiovascular risk remain relevant for both younger and older adults.” – by Darlene Dobkowski
Disclosures: The study was funded by the Bill & Melinda Gates Foundation. Roth reports no relevant financial disclosures. Feigin reports he received grants from the “Ageing Well” Program of the National Science Challenge from the Ministry of Business, Innovation and Employment of New Zealand, the Brain Research New Zealand Centre of Research Excellence and the Health Research Council of New Zealand. Please see the study for all other authors’ relevant financial disclosures.