Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021

作者：Ramón Martínez, Paula Muñoz Venturelli, Pedro Ordúñez, Felipe Fregni, Carlos Abanto, Matías Alet, Tony Fabián Álvarez, Pablo Amaya, Sebastián F. Ameriso, Antonio Araúz, Miguel A. Barboza, Hernán Bayona, Antonio Bernabé‐Ortiz, Juan Calleja, Vanessa Cano-Nigenda, Leonardo Augusto Carbonera, Rodrigo M. Carrillo‐Larco, Ángel Basilio Corredor-Quintero, Ana Cláudia de Souza, Claudio Jimenez, Fernando Laņas, Sheila Martins, Víctor Navia, Nelson Novarro, Verónica V. Olavarría, Bruce Ovbiagele, Kevin Pacheco‐Barrios, Octávio Marques Pontes‐Neto, Virginia Pujol, Alejandro A. Rabinstein, Julieta Rosales, Andrés Rosende, Gisele Sampaio Silva, Gustavo Saposnik, Souvik Sen, Fernando D. Testai, Victor Urrutia, Craig S. Anderson, Pablo M. Lavados · 发表于：The Lancet Regional Health - Americas · 年份：2025 · DOI：10.1016/j.lana.2025.101017 · 被引用次数：16 · 研究领域：Acute Ischemic Stroke Management、Cardiovascular Health and Risk Factors、Cerebrovascular and Carotid Artery Diseases

Background: Despite substantial declines in burden over time, stroke remains a public health threat in the Americas. This study aimed to assess the current magnitude, trends, and disparities in the estimates of stroke burden by sex and age in the Americas from 1990 to 2021. Methods: Estimates from the Global Burden of Disease, Injuries and Risk Factors Study 2021 were used to analyze incidence, prevalence, mortality, years of life lost due to premature death, years lived with disabilities, and disability-adjusted life years (DALYs) caused by stroke and its major subtypes stratified by age, and sex in the Americas from 1990 to 2021. We used Joinpoint regression analysis to estimate the average annual percent change (AAPC) of stroke mortality and disease burden outcomes and assessed trends. Findings: In 2021, there were 1.1 million (95% uncertainty interval: 1.0-1.2) new cases, 12.9 million (12.3-13.7) prevalent cases, 0.5 million (0.5-0.6) deaths, and 11.4 million (10.6-12.1) DALYs due to stroke in the Americas. The absolute number of stroke burden outcomes increased from 1990 to 2021, but their corresponding age-standardized rates significantly declined. A deceleration in reduction rates of burden outcomes for all strokes and most stroke subtypes occurred over the last decade, with pronounced difference between sexes mainly in incidence among younger groups. From 2015 to 2021, trends in incidence rates from all stroke and stroke subtypes reversed to increase in most age group...