Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016

Valery L. Feigin; Grant Nguyen; Kelly Cercy; Catherine O. Johnson; Tahiya Alam; Priyakumari G. Parmar; Amanuel A. Abajobir; Kalkidan H. Abate; Foad Abd-Allah; Ayenew N. Abejie; Gebre Y. Abyu; Zanfina Ademi; Gina Agarwal; Muktar B. Ahmed; Rufus O. Akinyemi; Rajaa Al-Raddadi; Leopold N. Aminde; Catherine Amlie-Lefond; Hossein Ansari; Hamid Asayesh; Solomon W. Asgedom; Tesfay M. Atey; Henok T. Ayele; Maciej Banach; Amitava Banerjee; Aleksandra Barac; Suzanne L. Barker-Collo; Till Barnighausen; Lars Barregard; Sanjay Basu; Neeraj Bedi; Masoud Behzadifar; Yannick Bejot; Derrick A. Bennett; Isabela M. Bensenor; Derbew F. Berhe; Dube J. Boneya; Michael Brainin; Ismael R. Campos-Nonato; Valeria Caso; Carlos A. Castaneda-Orjuela; Jacquelin C. Rivas; Ferran Catala-Lopez; Hanne Christensen; Michael H. Criqui; Albertino Damasceno; Lalit Dandona; Rakhi Dandona; Kairat Davletov; Barbora de Courten; Gabrielle deVeber; Klara Dokova; Dumessa Edessa; Matthias Endres; Emerito J. A. Faraon; Maryam S. Farvid; Florian Fischer; Kyle Foreman; Mohammad H. Forouzanfar; Seana L. Gall; Tsegaye T. Gebrehiwot; Johanna M. Geleijnse; Richard F. Gillum; Maurice Giroud; Alessandra C. Goulart; Rahul Gupta; Rajeev Gupta; Vladimir Hachinski; Randah R. Hamadeh; Graeme J. Hankey; Habtamu A. Hareri; Rasmus Havmoeller; Simon I. Hay; Mohamed I. Hegazy; Desalegn T. Hibstu; Spencer L. James; Panniyammakal Jeemon; Denny John; Jost B. Jonas; Jacek Jozwiak; Rizwan Kalani; Amit Kandel; Amir Kasaeian; Andre P. Kengne; Yousef S. 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 C. Malta; Abdullah A. Mamun; Lorenzo G. Mantovani; Sheila C. O. Martins; Kedar K. Mate; Mohsen Mazidi; 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 I. Musa; Ruxandra I. Negoi; Minh Nguyen; Quyen L. Nguyen; Trang H. Nguyen; Tung T. Tran; Thanh T. Nguyen; Dina Nur Anggraini Ningrum; Bo Norrving; Jean J. Noubiap; Martin J. O'Donnell; Andrew T. Olagunju; Oyere K. Onuma; Mayowa O. Owolabi; Mahboubeh Parsaeian; George C. Patton; Michael Piradov; Martin A. Pletcher; Farshad Pourmalek; V. Prakash; Mostafa Qorbani; Mahfuzar Rahman; Muhammad A. 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 A. Shaikh; Morteza Shamsizadeh; Kevin N. Sheth; Mekonnen Sisay; Min-Jeong Shin; Ivy Shiue; Diego A. S. Silva; Eugene Sobngwi; Michael Soljak; Reed J. D. Sorensen; Luciano A. Sposato; Saverio Stranges; Rizwan A. Suliankatchi; Rafael Tabares-Seisdedos; David Tanne; Cuong Tat Nguyen; J. S. Thakur; Amanda G. Thrift; David L. Tirschwell; Roman Topor-Madry; Bach X. Tran; Luong T. Nguyen; Thomas Truelsen; Nikolaos Tsilimparis; Stefanos Tyrovolas; Kingsley N. 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; Gregory A. Roth; GBD 2016 Lifetime Risk Stroke

doi:10.1056/NEJMoa1804492

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Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016

Journal article

Peer reviewed

Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016

Valery L. Feigin, Grant Nguyen, Kelly Cercy, Catherine O. Johnson, Tahiya Alam, Priyakumari G. Parmar, Amanuel A. Abajobir, Kalkidan H. Abate, Foad Abd-Allah, Ayenew N. Abejie, …

The New England journal of medicine, Vol.379(25), pp.2429-2437

20/12/2018

DOI: https://doi.org/10.1056/NEJMoa1804492

PMID: 30575491

Abstract

General & Internal Medicine

Life Sciences & Biomedicine

Medicine, General & Internal

Science & Technology

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.

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Title: Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016
Creators - without role: Valery L. Feigin - University of Washington
Grant Nguyen - University of Washington
Kelly Cercy - University of Washington
Catherine O. Johnson - University of Washington
Tahiya Alam - University of Washington
Priyakumari G. Parmar
Amanuel A. Abajobir - University of Queensland
Kalkidan H. Abate - Jimma University
Foad Abd-Allah - Cairo University
Ayenew N. Abejie - Debre Markos University
Gebre Y. Abyu - Mekelle University
Zanfina Ademi - University of Basel
Gina Agarwal - McMaster University
Muktar B. Ahmed - Coll Hlth Sci, Dept Epidemiol, Jimma, Ethiopia
Rufus O. Akinyemi - University of Ibadan
Rajaa Al-Raddadi - College Station Medical Center
Leopold N. Aminde - University of Queensland
Catherine Amlie-Lefond - Seattle Childrens Hosp, Seattle, WA USA
Hossein Ansari - Biostat
Hamid Asayesh - Supreme Council Of Health
Solomon W. Asgedom - Mekelle University
Tesfay M. Atey - Mekelle University
Henok T. Ayele - McGill University
Maciej Banach - College Station Medical Center
Amitava Banerjee - Farr Institute
Aleksandra Barac - University of Belgrade
Suzanne L. Barker-Collo - University of Auckland
Till Barnighausen - Supreme Council Of Health
Lars Barregard - University of Gothenburg
Sanjay Basu - Stanford University
Neeraj Bedi - Jazan University
Masoud Behzadifar - Lorestan University
Yannick Bejot - University of Burgundy
Derrick A. Bennett - University of Oxford
Isabela M. Bensenor - Univ Sao Paulo, Sao Paulo, Brazil
Derbew F. Berhe - Mekelle University
Dube J. Boneya - Debre Markos University
Michael Brainin - Universität für Weiterbildung Krems
Ismael R. Campos-Nonato - Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico
Valeria Caso - University of Perugia
Carlos A. Castaneda-Orjuela - Inst Nacl Salud, Colombian Natl Hlth Observ, Bogota, Colombia
Jacquelin C. Rivas - Caja Costarricense Seguro Social, San Jose, Costa Rica
Ferran Catala-Lopez - Universitat de València
Hanne Christensen - Bispebjerg Hosp, Copenhagen, Denmark
Michael H. Criqui - Univ Calif San Diego, La Jolla, CA 92093 USA
Albertino Damasceno - Eduardo Mondlane University
Lalit Dandona - Publ Hlth Fdn India, Gurugram, India
Rakhi Dandona - University of Washington
Kairat Davletov - Supreme Council Of Health
Barbora de Courten - Monash University
Gabrielle deVeber - University of Toronto
Klara Dokova - College Station Medical Center
Dumessa Edessa - Haramaya University
Matthias Endres - Charité - Universitätsmedizin Berlin
Emerito J. A. Faraon - University of the Philippines Manila
Maryam S. Farvid - Supreme Council Of Health
Florian Fischer - Bielefeld University
Kyle Foreman - University of Washington
Mohammad H. Forouzanfar - Seattle Genet, Seattle, WA USA
Seana L. Gall - University of Tasmania
Tsegaye T. Gebrehiwot - Jimma University
Johanna M. Geleijnse - Wageningen Univ, Div Human Nutr, Wageningen, Netherlands
Richard F. Gillum - Howard University
Maurice Giroud - Univ Hosp Dijon, Dijon, France
Alessandra C. Goulart - Univ Sao Paulo, Univ Hosp, Ctr Clin & Epidemiol Res Ctr, Sao Paulo, Brazil
Rahul Gupta - West Virginia Bur Publ Hlth, Charleston, WV USA
Rajeev Gupta - Eternal Heart Care Ctr & Res Inst, Jaipur, Rajasthan, India
Vladimir Hachinski - University of London
Randah R. Hamadeh - Arabian Gulf University
Graeme J. Hankey - University of Western Australia
Habtamu A. Hareri - Addis Ababa University
Rasmus Havmoeller - Karolinska Institutet
Simon I. Hay - University of Oxford
Mohamed I. Hegazy - Cairo University
Desalegn T. Hibstu - Hawassa University
Spencer L. James
Panniyammakal Jeemon - Ctr Chron Dis Control, New Delhi, India
Denny John - Campbell Collaborat, New Delhi, India
Jost B. Jonas - Heidelberg University
Jacek Jozwiak - Czestochowa Tech Univ, Inst Hlth & Nutr Sci, Czestochowa, Poland
Rizwan Kalani - University of Washington
Amit Kandel - University at Buffalo, State University of New York
Amir Kasaeian - University of Tehran
Andre P. Kengne - College Station Medical Center
Yousef S. Khader - College Station Medical Center
Abdur R. Khan - University of Louisville
Young-Ho Khang - College Station Medical Center
Jagdish Khubchandani - Ball State University
Daniel Kim - Northeastern Univ, Dept Hlth Sci, Boston, MA 02115 USA
Yun J. Kim - Xiamen University Malaysia
Mika Kivimaki - UCL, Dept Epidemiol & Publ Hlth, London, England
Yoshihiro Kokubo - Natl Cerebral & Cardiovasc Ctr, Dept Prevent Cardiol, Suita, Osaka, Japan
Dhaval Kolte - Brown University
Jacek A. Kopec - University of British Columbia
Soewarta Kosen - Natl Inst Hlth Res & Dev, Ctr Community Empowerment Hlth Policy & Humanitie, Jakarta, Indonesia
Michael Kravchenko
Rita Krishnamurthi - Auckland University of Technology
G. Anil Kumar - Publ Hlth Fdn India, Gurugram, India
Alessandra Lafranconi - University of Milano-Bicocca
Pablo M. Lavados - Univ Desarrollo, Clin Alemana, Neurol Serv, Santiago, Chile
Yirga Legesse - Mekelle University
Yongmei Li - College Station Medical Center
Xiaofeng Liang - Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China
Warren D. Lo - The Ohio State University
Stefan Lorkowski - Friedrich Schiller University Jena
Paulo A. Lotufo - Univ Sao Paulo, Sao Paulo, Brazil
Clement T. Loy - University of Sydney
Mark T. Mackay - Royal Childrens Hosp Melbourne, Melbourne, Vic, Australia
Hassan Magdy Abd El Razek - College Station Medical Center
Mahdi Mahdavi - University of Tehran
Azeem Majeed - Imperial Coll London, Dept Primary Care & Publ Hlth, London, England
Reza Malekzadeh - University of Tehran
Deborah C. Malta - Federal Reserve
Abdullah A. Mamun - University of Queensland
Lorenzo G. Mantovani - University of Milano-Bicocca
Sheila C. O. Martins - Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
Kedar K. Mate - McGill University
Mohsen Mazidi - Chalmers University of Technology
Suresh Mehata - Ipas Nepal, Kathmandu, Nepal
Toni Meier - Martin Luther University Halle-Wittenberg
Yohannes A. Melaku - Mekelle University
Walter Mendoza - United Nations
George A. Mensah - NHLBI, Ctr Translat Res & Implementat Sci, NIH, Bldg 10, Bethesda, MD 20892 USA
Atte Meretoja - University of Melbourne
Haftay B. Mezgebe - Mekelle University
Tomasz Miazgowski - University of Szczecin
Ted R. Miller - Pacific Inst Res & Evaluat, Calverton, MD USA
Norlinah M. Ibrahim - College Station Medical Center
Shafiu Mohammed - Ahmadu Bello University
Ali H. Mokdad - University of Washington
Mahmood Moosazadeh - College Station Medical Center
Andrew E. Moran - Columbia University
Kamarul I. Musa - Supreme Council Of Health
Ruxandra I. Negoi - College Station Medical Center
Minh Nguyen - University of Washington
Quyen L. Nguyen - Duy Tan University
Trang H. Nguyen - Trường ĐH Nguyễn Tất Thành
Tung T. Tran - Duy Tan University
Thanh T. Nguyen - Duy Tan University
Dina Nur Anggraini Ningrum - Semarang State Univ, Dept Publ Hlth, Semarang City, Indonesia
Bo Norrving - Skane Univ Hosp, Dept Clin Sci Lund, Neurol, Lund, Sweden
Jean J. Noubiap - College Station Medical Center
Martin J. O'Donnell - Natl Univ Ireland Galway, Galway, Ireland
Andrew T. Olagunju - University of Adelaide
Oyere K. Onuma - World Hlth Org, Geneva, Switzerland
Mayowa O. Owolabi - University of Ibadan
Mahboubeh Parsaeian - University of Tehran
George C. Patton - University of Melbourne
Michael Piradov - Res Ctr Neurol, Moscow, Russia
Martin A. Pletcher - University of Washington
Farshad Pourmalek - University of British Columbia
V. Prakash - Charotar Univ Sci & Technol, Anand, Gujarat, India
Mostafa Qorbani - College Station Medical Center
Mahfuzar Rahman - BRAC
Muhammad A. Rahman - La Trobe University
Rajesh K. Rai - Soc Hlth & Demog Surveillance, Suri, India
Annemarei Ranta - University of Otago
David Rawaf - Imperial Coll London, WHO Collaborating Ctr, London, England
Salman Rawaf - Imperial Coll London, London, England
Andre M. N. Renzaho - Western Sydney University
Stephen R. Robinson - RMIT University
Ramesh Sahathevan - Ballarat Hlth Serv, Ballarat, Vic, Australia
Amirhossein Sahebkar - College Station Medical Center
Joshua A. Salomon
Paola Santalucia - Fdn IRCCS Maggiore Hosp Policlin, Milan, Italy
Itamar S. Santos - College Station Medical Center
Benn Sartorius - University of KwaZulu-Natal
Aletta E. Schutte - Northwest Univ, Hypertens Africa Res Team, Potchefstroom, South Africa
Sadaf G. Sepanlou - University of Tehran
Azadeh Shafieesabet - College Station Medical Center
Masood A. Shaikh
Morteza Shamsizadeh - Supreme Council Of Health
Kevin N. Sheth - Yale University
Mekonnen Sisay - Haramaya University
Min-Jeong Shin - Korea Univ, Dept Publ Hlth Sci, Seoul, South Korea
Ivy Shiue - Martin Luther University Halle-Wittenberg
Diego A. S. Silva - Univ Fed Santa Catarina, Florianopolis, SC, Brazil
Eugene Sobngwi - Univ Yaounde, Yaounde, Cameroon
Michael Soljak - Imperial Coll London, Dept Primary Care & Publ Hlth, London, England
Reed J. D. Sorensen - University of Washington
Luciano A. Sposato - Western Univ, Dept Clin Neurol Sci, London, ON, Canada
Saverio Stranges - Western Univ, Schulich Sch Med Dent, Dept Epidemiol & Biostat, London, ON, Canada
Rizwan A. Suliankatchi - Minist Hlth, Riyadh, Saudi Arabia
Rafael Tabares-Seisdedos - Universitat de València
David Tanne - College Station Medical Center
Cuong Tat Nguyen - Duy Tan University
J. S. Thakur - Supreme Council Of Health
Amanda G. Thrift - Monash University
David L. Tirschwell - University of Washington
Roman Topor-Madry - Jagiellonian University
Bach X. Tran - Johns Hopkins University
Luong T. Nguyen - Duy Tan University
Thomas Truelsen - University of Copenhagen
Nikolaos Tsilimparis - Univ Heart Ctr Hamburg, Hamburg, Germany
Stefanos Tyrovolas - Universitat de Barcelona
Kingsley N. Ukwaja - Fed Teaching Hosp, Dept Internal Med, Abakaliki, Nigeria
Olalekan A. Uthman - University of Warwick
Yuri Varakin - Res Ctr Neurol, Moscow, Russia
Tommi Vasankari - UKK Inst Hlth Promot Res, Tampere, Finland
Narayanaswamy Venketasubramanian - Raffles Hosp, Raffles Neurosci Ctr, Singapore, Singapore
Vasiliy V. Vlassov - Supreme Council Of Health
Wenzhi Wang - Beijing Neurosurg Inst, Beijing, Peoples R China
Andrea Werdecker - Cohort
Charles D. A. Wolfe - Kings Coll London, Div Hlth & Social Care Res, London, England
Gelin Xu - Nanjing University
Yuichiro Yano - Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA
Naohiro Yonemoto - Kyoto University
Chuanhua Yu - Wuhan University
Zoubida Zaidi - Univ Hosp Setif, Setif, Algeria
Maysaa El Sayed Zaki - Mansoura University
Maigeng Zhou - University of Washington
Boback Ziaeian - Univ Calif Los Angeles, Los Angeles, CA USA
Ben Zipkin - University of Washington
Theo Vos - University of Washington
Mohsen Naghavi - University of Washington
Christopher J. L. Murray - University of Washington
Gregory A. Roth - University of Washington
GBD 2016 Lifetime Risk Stroke
Publication Details: The New England journal of medicine, Vol.379(25), pp.2429-2437
Publisher: Massachusetts Medical Soc
Number of pages: 9
Grant note: Bill and Melinda Gates Foundation; Bill & Melinda Gates Foundation MR/R024227/1 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC)
Identifiers: 9937794108331
Academic Unit: King Abdulaziz University; Alfaisal University
Language: English
Resource Type: Journal article