Epidemiology

• Stroke is a major health problem in the UK.
  • most people survive a first stroke, but often have significant morbidity (1)
  • first-ever stroke affects 230 people per 100,000 each year, with over 80,000 people hospitalised per year in England (2)
    
    
  • although the death rate has been falling, figures from the Sentinel Stroke National Audit Programme show that 13.6% of people admitted to hospital with stroke in England and Wales died (either in hospital or after being discharged from inpatient care) within 30 days
    
    
  • are approximately 1.2 million stroke survivors in the UK. The risk of recurrent stroke is 26% within 5 years of a first stroke and 39% by 10 years.
    • incidence increases exponentially with age, rising from about 3 per 10,000 in the third and fourth decades to about 300 per 10,000 in the eighth and ninth
      • total prevalence is estimated at 5-8 per 1,000 population over the age of 25 years
      • about 16% of all women and about 8% of all men are likely to die of a stroke
        
        
  • globally, mortality rates have declined in recent years in most industrialised countries, the rate of decline averaging 7% since 1970
    • exceptions include some eastern European countries which have witnessed an increase in stroke mortality
      • the downward trend is most likely due to changing risk factor levels - especially the treatment of hypertension
        
        
• the cumulative risk of recurrence of a stroke is high. Between one third and one half of survivors are likely to experience a second stroke within 5 years of the first
  
  
• stroke can occur at any age. The average age for stroke varies across the UK, with a median age of 77 years (interquartile range 67 to 85)

Global data from 1990 until 2019 suggests (3):

Stroke

• The prevalence rate of stroke, increased to 101 million cases (95% UI: 93.2-111 million).
• 6.55 Million individuals (95% UI: 6.00-7.02 million) died due to stroke.
• Total number of disability-adjusted life years (DALYs) caused by a stroke increased to 143 million cases (95% UI: 133-134 million) in 2019.
• There were 12.2 million incident stroke cases (95% UI: 11.0-13.6 million). Of those, 7.63 million (95% UI: 6.57-8.96 million) suffered from an ischemic stroke, 3.41 million (95% UI: 2.97-3.91 million) from intracerebral hemorrhages, and 1.18 million (95% UI: 1.01-1.39 million) from subarachnoid hemorrhages.
• Age-standardized mortality and DALYs due to stroke decreased from 1990 to 2019 globally. Death and DALYs was substantially higher in men compared to women.
• The age-standardized rates of DALYs and death were highest in Oceania, Central Asia, East Asia, Eastern Europe, and sub-Saharan Africa and lowest in Australasia, high-income Asia Pacific, Western Europe, and high-income North America.

Reference:

• (1) NICE (June 2008). The diagnosis and acute management of stroke and transient ischaemic attacks
• (2) NICE (May 2019). The diagnosis and acute management of stroke and transient ischaemic attack
• (3) Roth GA et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study.J Am Coll Cardiol. 2020;76:2982-3021. doi: 10.1016/j.jacc.2020.11.010.