Stroke incidence
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Global Stroke Incidence: Trends and Regional Differences
Stroke remains a major global health issue, with millions of new cases each year. In 2021, there were approximately 11.9 million new (incident) strokes worldwide, making stroke the third leading cause of death and the fourth leading cause of disability-adjusted life years (DALYs) globally . The global age-standardized incidence rate of stroke has shown a decrease since 1990, but the absolute number of strokes continues to rise due to population growth and aging 39.
Regional Stroke Incidence Rates
Asia: China and India
China has one of the highest stroke burdens in the world. Recent studies estimate the annual incidence of stroke in China to be between 246.8 and 442.1 per 100,000 people, with significant regional and rural-urban differences 56. The incidence and prevalence of stroke have increased over the past decades, especially in rural and northern regions 56. In India, the crude incidence of stroke ranges from 108 to 172 per 100,000 people per year, with considerable variation across different regions .
Americas: United States and Latin America
In the United States, the incidence rate for total (first-ever and recurrent) stroke was estimated at 259 per 100,000 population in 1995, with higher rates in older adults and males . In Latin America and the Caribbean, the pooled stroke incidence is about 255 per 100,000 person-years, with higher rates in men than women .
Europe and Oceania
Recent high-quality studies in Australia and New Zealand report age-standardized stroke incidence rates ranging from 76 to 119 per 100,000 population per year . In the Netherlands, stroke incidence in young adults (18–50 years) increased by 23% over a decade, mainly due to a rise in ischemic strokes .
Age, Sex, and Socioeconomic Disparities
Stroke incidence increases sharply with age and is generally higher in men than women, except in some regions and age groups 248. Notably, among people younger than 70 years, global stroke incidence rates have increased by 15% from 1990 to 2019 39. Low- and middle-income countries bear a disproportionate burden, with age-standardized stroke-related mortality and DALY rates being 3–4 times higher than in high-income countries 39.
Trends Over Time
While age-standardized stroke incidence rates have declined globally by about 17% since 1990, the total number of strokes has increased by 70% due to demographic changes 39. Some regions, such as southeast Asia, east Asia, and Oceania, have seen a stagnation or even an increase in stroke incidence in recent years . Historical data from Rochester, Minnesota, also show a major decline in stroke incidence from 1945 to 1974, especially among the elderly .
Stroke Subtypes and Risk Factors
Ischemic stroke is the most common subtype, accounting for about 62–65% of all incident strokes globally, followed by intracerebral hemorrhage (28%) and subarachnoid hemorrhage (6–10%) 369. The leading risk factors for stroke include high blood pressure, high body-mass index, high fasting plasma glucose, air pollution, and smoking 396.
Conclusion
Stroke incidence remains high worldwide, with significant regional, age, and socioeconomic disparities. Although age-standardized rates have declined, the absolute number of strokes continues to rise, especially in low- and middle-income countries and among younger populations. Effective prevention, improved surveillance, and equitable healthcare access are essential to reduce the global burden of stroke.
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