From the Guidelines
The global incidence of ischemic stroke is approximately 15 million cases annually, with around 80-90% of stroke cases caused by thrombotic or embolic events, as reported in the most recent study 1.
Global Incidence and Burden
The incidence of ischemic stroke varies significantly between regions, with high-income countries generally reporting incidence rates of 150-200 per 100,000 population annually, while developing regions may have rates ranging from 100-300 per 100,000, though underreporting is common in resource-limited settings.
Risk Factors and Prevention
Risk factors contributing to this high global burden include hypertension, diabetes, smoking, obesity, physical inactivity, and atrial fibrillation. Prevention strategies focus on controlling these modifiable risk factors through medications like antihypertensives, statins, antiplatelet agents (aspirin 75-100mg daily), and anticoagulants for atrial fibrillation (such as apixaban 5mg twice daily or warfarin with INR 2-3) as recommended by guidelines 1.
Age and Sex Distribution
The incidence increases dramatically with age, doubling for each decade after age 55, and men typically have a higher incidence than women until older ages.
Future Projections
The global stroke burden is expected to increase due to population aging and the growing prevalence of risk factors in developing economies, highlighting the importance of public health initiatives targeting stroke prevention, as emphasized in recent guidelines 1 and studies 1.
From the Research
Global Incidence of Ischemic Stroke
- The global incidence of ischemic stroke is increasing, with approximately 7,804,449 individuals affected by ischemic stroke in 2021, resulting in 3,591,499 deaths and 70,357,912 disability-adjusted life-years (DALYs) 2.
- The age-standardized incidence rate of ischemic stroke is declining, with an annual percentage change rate of -0.578% 2.
- The highest incidence rates of ischemic stroke are registered in developing nations and post-Soviet countries 3.
- In 2019, there were 12.2 million incident cases of stroke, with ischemic stroke constituting 62.4% of all incident strokes 4.
Regional Differences
- Regional differences in the incidence of ischemic stroke are observed, with the highest age-standardized incidence rates found in Southern Sub-Saharan Africa, Central Asia, Eastern Europe, and the Middle East 5.
- The lowest age-standardized incidence rates are found in high-income countries, such as those in North America and Western Europe 5.
- The frequency of recurrent strokes is determined by the clinical variants of the primary stroke, with the highest frequency of repeated strokes found in patients with partial anterior circulation infarcts (PACI) and total anterior circulation infarcts (TACI) 3.
Risk Factors
- The major risk factors for ischemic stroke include hypertension, environmental pollution, and low-density lipoprotein cholesterol (LDL-C) 2.
- The five leading risk factors for stroke are high systolic blood pressure, high body-mass index, high fasting plasma glucose, ambient particulate matter pollution, and smoking 4.
- The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index 4.