Ischemic stroke epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2],Seyedmahdi Pahlavani, M.D. [3]Aysha Anwar, M.B.B.S[4],Tarek Nafee, M.D. [5],Sara Mehrsefat, M.D. [6]

Overview

The worldwide incident of stroke is about 68 percent and it increases with age. It is more common in men. However, the mortality is more in women. the incident and mortality rates are high in African-American population and developing countries.

Epidemiology and Demographics

Incidence

  • Worldwide, the incidence of ischemic stroke is estimated to be 68 percent.[1]
    • Stroke is the third leading cause of death in the Western world, after heart disease and cancer, and causes 10% of deaths worldwide.[2]
  • The incidence of stroke increases exponentially from 30 years of age, and etiology varies by age.[3]

Age

  • Stroke can occur in all age groups. However, the incidence of stroke is less among individuals age less than 40 years of age and the risk increases with increasing age. [4]
  • According to National Health Interview survey data, there is increased number of hospitalizations in patients aged 5-44 years for ischemic stroke.
  • 95% of strokes occur in people age 45 and older; two-thirds of strokes occur in those over the age of 65.[5]
  • A person's risk of dying if he or she does have a stroke also increases with age.
    • However, stroke can occur at any age, including in fetuses.
  • According to WHO, stroke also occurs in about 8% of children with sickle cell disease. Stroke is the second leading killer of people under 20 years age who suffer from sickle-cell anemia.[6].
  • The incidence of stroke in people aged 18 to 50 years is estimated to be approximately 10%. [7]

Gender

  • Men are 1.25 times more likely to suffer cerebral vascular accidents than women.
    • However, 60% of deaths from stroke occur in women: Since women usually live longer, they are usually older when they suffer from strokes and are more often killed).[5]
  • Some risk factors for stroke apply only to women
    • Primary among these are pregnancy, childbirth, menopause and the treatment thereof (HRT).

Race

  • The risk of incidence of first stroke is twice in African-American population as compared to Caucasians with increased mortality rates.[4]

Geographical distribution

  • There is increased incidence and mortality rates of stroke in developing countries as compared to developed countries due to low socioeconomic status and heath facilities.
  • In the USA, the highest death rates from stroke are in the southeastern United States.[4]

Stroke in USA

  • Stroke is a leading cause of serious long-term disability
  • In USA, the incidence and mortality rates of stroke has significantly decreased compared to previous years.
  • From year 2003 to 2013, the mortality rates due to stroke declined by 18.5%.[7]
  • In 2013, stroke became the fifth leading cause of death.
  • The case fatality rate of stroke is estimated to be 41.7 deaths per 100, 000 population[7]
  • The incidence of new (610, 000) or recurrent stroke (185, 000) is estimated to be 795000 people annually or 250 cases per 100, 000.[7]
  • It is estimated that one incidence of stroke happens every 4 sec with death occurs every 4 min.[7]
  • About 87% of all strokes are ischemic strokes[4]
  • Stroke costs the United States an estimated $34 billion each year[4]

Worldwide

  • According to WHO, the incidence of stroke is estimated to be 15 million people annually, worldwide.[6].
  • Out of these, 5 million die and 5 million are left permanently disabled.[6].

References

  1. Murray CJ, Lopez AD (1997). "Mortality by cause for eight regions of the world: Global Burden of Disease Study". Lancet. 349 (9061): 1269–76. PMID 9142060.
  2. The World health report 2004. Annex Table 2: Deaths by cause, sex and mortality stratum in WHO regions, estimates for 2002 (PDF). Geneva: World Health Organization. 2004.
  3. Ellekjær, H (1997). "Epidemiology of Stroke in Innherred, Norway, 1994 to 1996 : Incidence and 30-Day Case-Fatality Rate". Stroke. 28: 2180–2184. PMID 9368561. Retrieved 2008-01-22. Unknown parameter |coauthors= ignored (help)
  4. 4.0 4.1 4.2 4.3 4.4 http://www.cdc.gov/stroke/facts.htm Accessed on November 3, 2016
  5. 5.0 5.1 National Institute of Neurological Disorders and Stroke (NINDS) (1999). "Stroke: Hope Through Research". National Institutes of Health.
  6. 6.0 6.1 6.2 Mackay, Judith, et al. The atlas of heart disease and stroke. World Health Organization, 2004 Accessed on November 3 2016
  7. 7.0 7.1 7.2 7.3 7.4 Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ; et al. (2016). "Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association". Circulation. 133 (4): e38–360. doi:10.1161/CIR.0000000000000350. PMID 26673558.


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