Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 2429-2437 |
| Number of pages | 9 |
| Journal | New England Journal of Medicine |
| Volume | 379 |
| Issue number | 25 |
| DOIs | |
| Publication status | Published - 20 Dec 2018 |
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Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016. / Feigin, Valery L.; Nguyen, Grant; Cercy, Kelly; Johnson, Catherine O.; Alam, Tahiya; Parmar, Priyakumari G.; Abajobir, Amanuel A.; Abate, Kalkidan H.; Abd-Allah, Foad; Abejie, Ayenew N.; Abyu, Gebre Y.; Ademi, Zanfina; Agarwal, Gina; Ahmed, Muktar B.; Akinyemi, Rufus O.; Al-Raddadi, Rajaa; Aminde, Leopold N.; Amlie-Lefond, Catherine; Ansari, Hossein; Asayesh, Hamid; Asgedom, Solomon W.; Atey, Tesfay M.; Ayele, Henok T.; Banach, Maciej; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L.; Bärnighausen, Till; Barregard, Lars; Basu, Sanjay; Bedi, Neeraj; Behzadifar, Masoud; Béjot, Yannick; Bennett, Derrick A.; Bensenor, Isabela M.; Berhe, Derbew F.; Boneya, Dube J.; Brainin, Michael; Campos-Nonato, Ismael R.; Caso, Valeria; Castañeda-Orjuela, Carlos A.; Rivas, Jacquelin C.; Catalá-López, Ferrán; Christensen, Hanne; Criqui, Michael H.; Damasceno, Albertino; Dandona, Lalit; Dandona, Rakhi; Davletov, Kairat; de Courten, Barbora; deVeber, Gabrielle; Dokova, Klara; Edessa, Dumessa; Endres, Matthias; Faraon, Emerito J.A.; Farvid, Maryam S.; Fischer, Florian; Foreman, Kyle; Forouzanfar, Mohammad H.; Gall, Seana L.; Gebrehiwot, Tsegaye T.; Geleijnse, Johanna M.; Gillum, Richard F.; Giroud, Maurice; Goulart, Alessandra C.; Gupta, Rahul; Gupta, Rajeev; Hachinski, Vladimir; Hamadeh, Randah R.; Hankey, Graeme J.; Hareri, Habtamu A.; Havmoeller, Rasmus; Hay, Simon I.; Hegazy, Mohamed I.; Hibstu, Desalegn T.; James, Spencer L.; Jeemon, Panniyammakal; John, Denny; Jonas, Jost B.; Jóźwiak, Jacek; Kalani, Rizwan; Kandel, Amit; Kasaeian, Amir; Kengne, Andre P.; Khader, Yousef S.; Khan, Abdur R.; Khang, Young Ho; Khubchandani, Jagdish; Kim, Daniel; Kim, Yun J.; Kivimaki, Mika; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A.; Kosen, Soewarta; Kravchenko, Michael; Krishnamurthi, Rita; Anil Kumar, G.; Lafranconi, Alessandra; Lavados, Pablo M.; Legesse, Yirga; Li, Yongmei; Liang, Xiaofeng; Lo, Warren; Lorkowski, Stefan; Lotufo, Paulo A.; Loy, Clement T.; Mackay, Mark T.; Abd El Razek, Hassan Magdy; Mahdavi, Mahdi; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah C.; Mamun, Abdullah A.; Mantovani, Lorenzo G.; Martins, Sheila C.O.; Mate, Kedar K.; Mazidi, Mohsen; Mehata, Suresh; Meier, Toni; Melaku, Yohannes A.; Mendoza, Walter; Mensah, George A.; Meretoja, Atte; Mezgebe, Haftay B.; Miazgowski, Tomasz; Miller, Ted R.; Ibrahim, Norlinah M.; Mohammed, Shafiu; Mokdad, Ali H.; Moosazadeh, Mahmood; Moran, Andrew E.; Musa, Kamarul I.; Negoi, Ruxandra I.; Nguyen, Minh; Nguyen, Quyen L.; Nguyen, Trang H.; Tran, Tung T.; Nguyen, Thanh T.; Anggraini Ningrum, Dina Nur; Norrving, Bo; Noubiap, Jean J.; O'Donnell, Martin J.; Olagunju, Andrew T.; Onuma, Oyere K.; Owolabi, Mayowa O.; Parsaeian, Mahboubeh; Patton, George C.; Piradov, Michael; Pletcher, Martin A.; Pourmalek, Farshad; Prakash, V.; Qorbani, Mostafa; Rahman, Mahfuzar; Rahman, Muhammad A.; Rai, Rajesh K.; Ranta, Annemarei; Rawaf, David; Rawaf, Salman; Renzaho, Andre M.N.; Robinson, Stephen R.; Sahathevan, Ramesh; Sahebkar, Amirhossein; Salomon, Joshua A.; Santalucia, Paola; Santos, Itamar S.; Sartorius, Benn; Schutte, Aletta E.; Sepanlou, Sadaf G.; Shafieesabet, Azadeh; Shaikh, Masood A.; Shamsizadeh, Morteza; Sheth, Kevin N.; Sisay, Mekonnen; Shin, Min Jeong; Shiue, Ivy; Silva, Diego A.S.; Sobngwi, Eugene; Soljak, Michael; Sorensen, Reed J.D.; Sposato, Luciano A.; Stranges, Saverio; Suliankatchi, Rizwan A.; Tabarés-Seisdedos, Rafael; Tanne, David; Tat Nguyen, Cuong; Thakur, J. S.; Thrift, Amanda G.; Tirschwell, David L.; Topor-Madry, Roman; Tran, Bach X.; Nguyen, Luong T.; Truelsen, Thomas; Tsilimparis, Nikolaos; Tyrovolas, Stefanos; Ukwaja, Kingsley N.; Uthman, Olalekan A.; Varakin, Yuri; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy V.; Wang, Wenzhi; Werdecker, Andrea; Wolfe, Charles D.A.; Xu, Gelin; Yano, Yuichiro; Yonemoto, Naohiro; Yu, Chuanhua; Zaidi, Zoubida; El Sayed Zaki, Maysaa; Zhou, Maigeng; Ziaeian, Boback; Zipkin, Ben; Vos, Theo; Naghavi, Mohsen; Murray, Christopher J.L.
In: New England Journal of Medicine, Vol. 379, No. 25, 20.12.2018, p. 2429-2437.Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016
AU - Feigin, Valery L.
AU - Nguyen, Grant
AU - Cercy, Kelly
AU - Johnson, Catherine O.
AU - Alam, Tahiya
AU - Parmar, Priyakumari G.
AU - Abajobir, Amanuel A.
AU - Abate, Kalkidan H.
AU - Abd-Allah, Foad
AU - Abejie, Ayenew N.
AU - Abyu, Gebre Y.
AU - Ademi, Zanfina
AU - Agarwal, Gina
AU - Ahmed, Muktar B.
AU - Akinyemi, Rufus O.
AU - Al-Raddadi, Rajaa
AU - Aminde, Leopold N.
AU - Amlie-Lefond, Catherine
AU - Ansari, Hossein
AU - Asayesh, Hamid
AU - Asgedom, Solomon W.
AU - Atey, Tesfay M.
AU - Ayele, Henok T.
AU - Banach, Maciej
AU - Banerjee, Amitava
AU - Barac, Aleksandra
AU - Barker-Collo, Suzanne L.
AU - Bärnighausen, Till
AU - Barregard, Lars
AU - Basu, Sanjay
AU - Bedi, Neeraj
AU - Behzadifar, Masoud
AU - Béjot, Yannick
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Berhe, Derbew F.
AU - Boneya, Dube J.
AU - Brainin, Michael
AU - Campos-Nonato, Ismael R.
AU - Caso, Valeria
AU - Castañeda-Orjuela, Carlos A.
AU - Rivas, Jacquelin C.
AU - Catalá-López, Ferrán
AU - Christensen, Hanne
AU - Criqui, Michael H.
AU - Damasceno, Albertino
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Davletov, Kairat
AU - de Courten, Barbora
AU - deVeber, Gabrielle
AU - Dokova, Klara
AU - Edessa, Dumessa
AU - Endres, Matthias
AU - Faraon, Emerito J.A.
AU - Farvid, Maryam S.
AU - Fischer, Florian
AU - Foreman, Kyle
AU - Forouzanfar, Mohammad H.
AU - Gall, Seana L.
AU - Gebrehiwot, Tsegaye T.
AU - Geleijnse, Johanna M.
AU - Gillum, Richard F.
AU - Giroud, Maurice
AU - Goulart, Alessandra C.
AU - Gupta, Rahul
AU - Gupta, Rajeev
AU - Hachinski, Vladimir
AU - Hamadeh, Randah R.
AU - Hankey, Graeme J.
AU - Hareri, Habtamu A.
AU - Havmoeller, Rasmus
AU - Hay, Simon I.
AU - Hegazy, Mohamed I.
AU - Hibstu, Desalegn T.
AU - James, Spencer L.
AU - Jeemon, Panniyammakal
AU - John, Denny
AU - Jonas, Jost B.
AU - Jóźwiak, Jacek
AU - Kalani, Rizwan
AU - Kandel, Amit
AU - Kasaeian, Amir
AU - Kengne, Andre P.
AU - Khader, Yousef S.
AU - Khan, Abdur R.
AU - Khang, Young Ho
AU - Khubchandani, Jagdish
AU - Kim, Daniel
AU - Kim, Yun J.
AU - Kivimaki, Mika
AU - Kokubo, Yoshihiro
AU - Kolte, Dhaval
AU - Kopec, Jacek A.
AU - Kosen, Soewarta
AU - Kravchenko, Michael
AU - Krishnamurthi, Rita
AU - Anil Kumar, G.
AU - Lafranconi, Alessandra
AU - Lavados, Pablo M.
AU - Legesse, Yirga
AU - Li, Yongmei
AU - Liang, Xiaofeng
AU - Lo, Warren
AU - Lorkowski, Stefan
AU - Lotufo, Paulo A.
AU - Loy, Clement T.
AU - Mackay, Mark T.
AU - Abd El Razek, Hassan Magdy
AU - Mahdavi, Mahdi
AU - Majeed, Azeem
AU - Malekzadeh, Reza
AU - Malta, Deborah C.
AU - Mamun, Abdullah A.
AU - Mantovani, Lorenzo G.
AU - Martins, Sheila C.O.
AU - Mate, Kedar K.
AU - Mazidi, Mohsen
AU - Mehata, Suresh
AU - Meier, Toni
AU - Melaku, Yohannes A.
AU - Mendoza, Walter
AU - Mensah, George A.
AU - Meretoja, Atte
AU - Mezgebe, Haftay B.
AU - Miazgowski, Tomasz
AU - Miller, Ted R.
AU - Ibrahim, Norlinah M.
AU - Mohammed, Shafiu
AU - Mokdad, Ali H.
AU - Moosazadeh, Mahmood
AU - Moran, Andrew E.
AU - Musa, Kamarul I.
AU - Negoi, Ruxandra I.
AU - Nguyen, Minh
AU - Nguyen, Quyen L.
AU - Nguyen, Trang H.
AU - Tran, Tung T.
AU - Nguyen, Thanh T.
AU - Anggraini Ningrum, Dina Nur
AU - Norrving, Bo
AU - Noubiap, Jean J.
AU - O'Donnell, Martin J.
AU - Olagunju, Andrew T.
AU - Onuma, Oyere K.
AU - Owolabi, Mayowa O.
AU - Parsaeian, Mahboubeh
AU - Patton, George C.
AU - Piradov, Michael
AU - Pletcher, Martin A.
AU - Pourmalek, Farshad
AU - Prakash, V.
AU - Qorbani, Mostafa
AU - Rahman, Mahfuzar
AU - Rahman, Muhammad A.
AU - Rai, Rajesh K.
AU - Ranta, Annemarei
AU - Rawaf, David
AU - Rawaf, Salman
AU - Renzaho, Andre M.N.
AU - Robinson, Stephen R.
AU - Sahathevan, Ramesh
AU - Sahebkar, Amirhossein
AU - Salomon, Joshua A.
AU - Santalucia, Paola
AU - Santos, Itamar S.
AU - Sartorius, Benn
AU - Schutte, Aletta E.
AU - Sepanlou, Sadaf G.
AU - Shafieesabet, Azadeh
AU - Shaikh, Masood A.
AU - Shamsizadeh, Morteza
AU - Sheth, Kevin N.
AU - Sisay, Mekonnen
AU - Shin, Min Jeong
AU - Shiue, Ivy
AU - Silva, Diego A.S.
AU - Sobngwi, Eugene
AU - Soljak, Michael
AU - Sorensen, Reed J.D.
AU - Sposato, Luciano A.
AU - Stranges, Saverio
AU - Suliankatchi, Rizwan A.
AU - Tabarés-Seisdedos, Rafael
AU - Tanne, David
AU - Tat Nguyen, Cuong
AU - Thakur, J. S.
AU - Thrift, Amanda G.
AU - Tirschwell, David L.
AU - Topor-Madry, Roman
AU - Tran, Bach X.
AU - Nguyen, Luong T.
AU - Truelsen, Thomas
AU - Tsilimparis, Nikolaos
AU - Tyrovolas, Stefanos
AU - Ukwaja, Kingsley N.
AU - Uthman, Olalekan A.
AU - Varakin, Yuri
AU - Vasankari, Tommi
AU - Venketasubramanian, Narayanaswamy
AU - Vlassov, Vasiliy V.
AU - Wang, Wenzhi
AU - Werdecker, Andrea
AU - Wolfe, Charles D.A.
AU - Xu, Gelin
AU - Yano, Yuichiro
AU - Yonemoto, Naohiro
AU - Yu, Chuanhua
AU - Zaidi, Zoubida
AU - El Sayed Zaki, Maysaa
AU - Zhou, Maigeng
AU - Ziaeian, Boback
AU - Zipkin, Ben
AU - Vos, Theo
AU - Naghavi, Mohsen
AU - Murray, Christopher J.L.
PY - 2018/12/20
Y1 - 2018/12/20
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85058877243&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa1804492
DO - 10.1056/NEJMoa1804492
M3 - Article
C2 - 30575491
AN - SCOPUS:85058877243
VL - 379
SP - 2429
EP - 2437
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 25
ER -