Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the Global Burden of Disease Study 2010

Abstract

BACKGROUND: The burden of ischaemic and haemorrhagic stroke varies between regions and over time. With differences in prognosis, prevalence of risk factors, and treatment strategies, knowledge of stroke pathological type is important for targeted region-specific health-care planning for stroke and could inform priorities for type-specific prevention strategies. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010. METHODS: We searched Medline, Embase, LILACS, Scopus, PubMed, Science Direct, Global Health Database, the WHO library, and regional databases from 1990 to 2012 to identify relevant studies published between 1990 and 2010. We applied the GBD 2010 analytical technique (DisMod-MR) to calculate regional and country-specific estimates for ischaemic and haemorrhagic stroke incidence, mortality, mortality-to-incidence ratio, and disability-adjusted life-years (DALYs) lost, by age group (aged <75 years, ≥ 75 years, and in total) and country income level (high-income and low-income and middle-income) for 1990, 2005, and 2010. FINDINGS: We included 119 studies (58 from high-income countries and 61 from low-income and middle-income countries). Worldwide, the burden of ischaemic and haemorrhagic stroke increased significantly between 1990 and 2010 in terms of the absolute number of people with incident ischaemic and haemorrhagic stroke (37% and 47% increase, respectively), number of deaths (21% and 20% increase), and DALYs lost (18% and 14% increase). In the past two decades in high-income countries, incidence of ischaemic stroke reduced significantly by 13% (95% CI 6-18), mortality by 37% (19-39), DALYs lost by 34% (16-36), and mortality-to-incidence ratios by 21% (10-27). For haemorrhagic stroke, incidence reduced significantly by 19% (1-15), mortality by 38% (32-43), DALYs lost by 39% (32-44), and mortality-to-incidence ratios by 27% (19-35). By contrast, in low-income and middle-income countries, we noted a significant increase of 22% (5-30) in incidence of haemorrhagic stroke and a 6% (-7 to 18) non-significant increase in the incidence of ischaemic stroke. Mortality rates for ischaemic stroke fell by 14% (9-19), DALYs lost by 17% (-11 to 21%), and mortality-to-incidence ratios by 16% (-12 to 22). For haemorrhagic stroke in low-income and middle-income countries, mortality rates reduced by 23% (-18 to 25%), DALYs lost by 25% (-21 to 28), and mortality-to-incidence ratios by 36% (-34 to 28). INTERPRETATION: Although age-standardised mortality rates for ischaemic and haemorrhagic stroke have decreased in the past two decades, the absolute number of people who have these stroke types annually, and the number with related deaths and DALYs lost, is increasing, with most of the burden in low-income and middle-income countries. Further study is needed in these countries to identify which subgroups of the population are at greatest risk and who could be targeted for preventive efforts.

Shown for reading. Its publisher allows quoting it, not republishing it.

References 29

1. 1.

   Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355-69.

   Not in our library10.1016/s1474-4422(09)70025-0

2. 2.

   van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167-76.

   Not in our library10.1016/s1474-4422(09)70340-0

3. 3.

   de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007;78:1365-72.

   Not in our library10.1136/jnnp.2007.117655

4. 4.

   Donnan GA, Hankey GJ, Davis SM. Intracerebral haemorrhage: a need for more data and new research directions. Lancet Neurol. 2010;9:133-34.

   Not in our library10.1016/s1474-4422(10)70001-6

5. 5.

   O’Donnell M, Yusuf S, O’Donnell M, Yusuf S. Tackling the global burden of stroke: the need for large-scale international studies. Lancet Neurol. 2009;8:306-07.

   Not in our library10.1016/s1474-4422(09)70024-9

6. 6.

   Feigin VL, Krishnamurthi R. Stroke prevention in the developing world. Stroke. 2011;42:3655-58.

   Not in our library10.1161/strokeaha.110.596858

7. 7.

   Murray CJL, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, et al. GBD 2010: design, definitions, and metrics. Lancet. 2012;380:2063-66.

   Not in our library10.1016/s0140-6736(12)61899-6

8. 8.

   Bennett DA, Anderson LM, Nair N, et al. Methodology of the global and regional burden of stroke study. Neuroepidemiology. 2012;38:30-40.

   Not in our library10.1159/000334744

9. 9.

   Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke in 1990–2010. Part 1: incidence, mortality, prevalence, and disability-adjusted life-year lost. Lancet. 2013.

   Not in our library

10. 10.
    Modeling causes of death: an integrated approach using CODEm · 2012

    No notice
11. 11.

    Wang H, Dwyer-Lindgren L, Lofgren KT, et al. Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2071-94.

    Not in our library10.1016/s0140-6736(12)61719-x

12. 12.

    Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue M. Age standardization of rates: a new WHO standard. 2001.

    Not in our library

13. 13.

    Omran AR. The epidemiologic transition. A theory of the epidemiology of population change 1971. Bull World Health Organ. 2001;79:161-70.

    Not in our library

14. 14.

    Yusuf S, Reddy S, Stephanie O, Sonia A. Global burden of cardiovascular diseases part I: general considerations, the epidemiologic transisiton, risk factors, and the impact of urbanization. Circulation. 2001;104:2746-53.

    Not in our library10.1161/hc4601.099487

15. 15.

    Mattei J, Malik V, Wedick NM, et al. A symposium and workshop report from the Global Nutrition and Epidemiologic Transition Initiative: nutrition transition and the global burden of type 2 diabetes. Brit J Nutr. 2012;108:1325-35.

    Not in our library10.1017/s0007114512003200

16. 16.

    Jiang B, Wang WZ, Chen H, et al. Incidence and trends of stroke and its subtypes in China: results from three large cities. Stroke. 2006;37:63-68.

    Not in our library10.1161/01.str.0000194955.34820.78

17. 17.

    Hu SS, Kong LZ, Gao RL, et al. Outline of the report on cardiovascular disease in China, 2010. Biomed Environ Sci. 2012;25:251-56.

    Not in our library10.3967/0895-3988.2012.03.001

18. 18.

    Jia Q, Liu LP, Wang YJ. Stroke in China. Clinic Exp Pharmacol Physiol. 2010;37:259-64.

    Not in our library10.1111/j.1440-1681.2009.05290.x

19. 19.

    Jha P, Jacob B, Gajalakshmi V, et al. A nationally representative case-control study of smoking and death in India. N Engl J Med. 2008;358:1137-47.

    Not in our library10.1056/nejmsa0707719

20. 20.

    Zaridze D, Brennan P, Boreham J, et al. Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48 557 adult deaths. Lancet. 2009;373:2201-14.

    Not in our library10.1016/s0140-6736(09)61034-5

21. 21.

    Leon DA, Saburova L, Tomkins S, McKee M, Shkolnikov VM. Alcohol consumption and public health in Russia. Lancet. 2007;370:561.

    Not in our library10.1016/s0140-6736(07)61281-1

22. 22.

    Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224-60.

    Not in our library10.1016/s0140-6736(12)61766-8

23. 23.

    Norrving B, Kissela B. The global burden of stroke and need for a continuum of care. Neurology. 2013;80:S5-12.

    Not in our library10.1212/wnl.0b013e3182762397

24. 24.

    Sajjad A, Chowdhury R, Felix JF, et al. A systematic evaluation of stroke surveillance studies in low- and middle-income countries. Neurology. 2013;80:677-84.

    Not in our library10.1212/wnl.0b013e318281cc6e

25. 25.

    Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855-64.

    Not in our library10.1161/hc4701.099488

26. 26.

    Gaziano TA, Galea G, Reddy KS. Scaling up interventions for chronic disease prevention: the evidence. Lancet. 2007;370:1939-46.

    Not in our library10.1016/s0140-6736(07)61697-3

27. 27.

    Asaria P, Chisholm D, Mathers C, Ezzati M, Beaglehole R. Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use. Lancet. 2007;370:2044-53.

    Not in our library10.1016/s0140-6736(07)61698-5

28. 28.

    Samb B, Desai N, Nishtar S, et al. Prevention and management of chronic disease: A litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376:1785-97.

    Not in our library10.1016/s0140-6736(10)61353-0

29. 29.

    Lawlor DA, Smith GD, Leon DA, Sterne JAC, Ebrahim S. Secular trends in mortality by stroke subtype in the 20th century: a retrospective analysis. Lancet. 2002;360:1818-23.

    Not in our library10.1016/s0140-6736(02)11769-7

Cited by papers we hold 13

• Association between minimally invasive surgery and late seizures in patients with intracerebral hemorrhage: A propensity score matching study · 2022
  Not checked
• The economic burden of stroke: a systematic review of cost of illness studies · 2021
  No notice
• Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches · 2020
  No notice
• Early Life Body Size in Relation to First Intracerebral or Subarachnoid Hemorrhage · 2019
  Not checked
• Xingnaojing for Moderate-to-severe Acute ischemic Stroke (XMAS): study protocol for a randomized controlled trial · 2017
  Not checked
• Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies · 2017
  No notice
• The Neuroprotection of Liraglutide Against Ischaemia-induced Apoptosis through the Activation of the PI3K/AKT and MAPK Pathways · 2016
  No notice
• Stroke injury, cognitive impairment and vascular dementia · 2016
  No notice
• Spatiotemporal analysis of the relationship between socioeconomic factors and stroke in the Portuguese mainland population under 65 years old · 2015
  Not checked
• The burden of stroke in Africa: a glance at the present and a glimpse into the future: review article · 2015
  No notice
• A randomized controlled behavioral intervention trial to improve medication adherence in adult stroke patients with prescription tailored Short Messaging Service (SMS)-SMS4Stroke study · 2015
  No notice
• Mortality from cardiovascular diseases in sub-Saharan Africa, 1990–2013: a systematic analysis of data from the Global Burden of Disease Study 2013: cardiovascular topic · 2015
  No notice
• Targeting stroke risk and improving outcomes in patients with atrial fibrillation in Latin America
  Not checked

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.