Skip to content
naulon
Get started

No retraction, correction or concern found when last checked on Oct 29, 2026.

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

The GBD 2016 Lifetime Risk of Stroke Collaborators

New England Journal of Medicine · 2018

doi:10.1056/nejmoa1804492

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

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

References 20

  1. 1.
    Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 · 2017
    No notice
  2. 2.
    Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016 · 2017
    No notice
  3. 3.

    Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45:161-176

    Not in our library10.1159/000441085

  4. 4.

    Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. Neurology. 2016;15:913-924

    Not in our library10.1016/s1474-4422(16)30073-4

  5. 5.

    Lloyd-Jones DM, Larson MG, Beiser A, Levy D. Lifetime risk of developing coronary heart disease. Lancet. 1999;353:89-92

    Not in our library10.1016/s0140-6736(98)10279-9

  6. 6.

    Seshadri S, Wolf PA. Lifetime risk of stroke and dementia: current concepts, and estimates from the Framingham Study. Lancet Neurology. 2007;6:1106-1114

    Not in our library10.1016/s1474-4422(07)70291-0

  7. 7.

    Wang Y, Liu J, Wang W, Wang M, Qi Y, Xie W, et al. Lifetime risk of stroke in youngaged and middle-aged Chinese population: the Chinese Multi-Provincial Cohort Study. Journal of hypertension. 2016;34:2434-2440

    Not in our library10.1097/hjh.0000000000001084

  8. 8.

    Turin TC, Kokubo Y, Murakami Y, Higashiyama A, Rumana N, Watanabe M, et al. Lifetime risk of stroke in Japan. Stroke. 2010;41:1552-1554

    Not in our library10.1161/strokeaha.110.581363

  9. 9.

    Leening MJG, Ferket BS, Steyerberg EW, Kavousi M, Deckers JW, Nieboer D, et al. Sex differences in lifetime risk and first manifestation of cardiovascular disease: Prospective population based cohort study. BMJ (Online). 2014;349

    Not in our library10.1136/bmj.g5992

  10. 10.

    Berry JD, Dyer A, Cai X, Garside DB, Ning H, Thomas A, et al. Lifetime risks of cardiovascular disease. New Engl. J. Med. 2012;366:321-329

    Not in our library10.1056/nejmoa1012848

  11. 11.

    Turin TC, Okamura T, Afzal AR, Rumana N, Watanabe M, Higashiyama A, et al. Hypertension and lifetime risk of stroke. Journal of hypertension. 2016;34:116-122

    Not in our library10.1097/hjh.0000000000000753

  12. 12.

    Takahashi I, Geyer SM, Nishi N, Ohshita T, Takahashi T, Akahoshi M, et al. Lifetime risk of stroke and impact of hypertension: Estimates from the adult health study in Hiroshima and Nagasaki. Hypertension Research. 2011;34:649-654

    Not in our library10.1038/hr.2011.7

  13. 13.

    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. The Lancet Neurology. 2009;8:355-369

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

  14. 14.
    Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016 · 2017
    No notice
  15. 15.

    Global Burden of Disease Study 2015. Global Burden of Disease Study 2015 (GBD 2015) Socio-Demographic Index (SDI) 1980–2015. Seattle, United States: Institute for Health Metrics and Evaluation (IHME); 2016.

    Not in our library

  16. 16.

    Human development report 2009: overcoming barriers—human mobility and development. New York: United Nations; 2009.

    Not in our library

  17. 17.

    Feigin VL, Norrving B, Mensah GA. Global Burden of Stroke. Circulation Research. 2017;120:439-448

    Not in our library10.1161/circresaha.116.308413

  18. 18.

    Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Au R, Kannel WB, et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke. 2006;37:345-350

    Not in our library10.1161/01.str.0000199613.38911.b2

  19. 19.

    Zhao D, Liu J, Wang W, Zeng Z, Cheng J, Liu J, et al. Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICABeijing Project. Stroke. 2008;39:1668-1674

    Not in our library10.1161/strokeaha.107.502807

  20. 20.
    Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 · 2017
    No notice

Cited by papers we hold 23

and 3 more

Reads

Read by people on this page

None yet.

Checked or read by AI through naulon

None yet.

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.

Are you an author?

Is this your paper?

Claim it to add your note and be paid when agents cite it. Free.