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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

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dc.contributor.authorMartinez, Ramón
dc.contributor.authorMunoz Venturelli, Paula
dc.contributor.authorOrdunez, Pero
dc.contributor.authorFregni, Felipe
dc.contributor.authorAbanto, Carlos
dc.contributor.authorAlet, Matias
dc.contributor.authorAlvarez, Tony
dc.contributor.authorAmaya, Pablo
dc.contributor.authorAmeriso, Sebastian
dc.contributor.authorArauz, Antonio
dc.contributor.authorBarboza, Miguel
dc.contributor.authorBayona, Hernán
dc.contributor.authorOrtiz, Antonio
dc.contributor.authorCalleja, Juan
dc.contributor.authorCano, Vanessa
dc.contributor.authorCarbonera, Leonardo
dc.contributor.authorCarrillo, Rodrigo
dc.contributor.authorCorredor, Angel
dc.contributor.authorDe Souza, Ana
dc.contributor.authorJimenez, Claudio
dc.contributor.authorLanas, Fernando
dc.contributor.authorMartins, Sheila
dc.contributor.authorNavia, Víctor
dc.contributor.authorNovarro, Nelson
dc.contributor.authorOlavarría, Verónica V.
dc.contributor.authorOvbiagele, Bruce
dc.contributor.authorPachecho, Kevin
dc.contributor.authorPontes, Octavio
dc.contributor.authorPujol, Virginia
dc.contributor.authorRabinstein, Alejandro
dc.contributor.authorRosales, Julieta
dc.contributor.authorRosende, Andrés
dc.contributor.authorSampaio, Gisele
dc.contributor.authorSaposnik, Gustavo
dc.contributor.authorSen, Souvik
dc.contributor.authorTestai, Fernando
dc.contributor.authorUrrutia, Victor
dc.contributor.authorAnderson, Craig
dc.contributor.authorLavados, Pablo
dc.date.accessioned2026-08-05T21:56:46Z
dc.date.available2026-08-05T21:56:46Z
dc.date.issued2025
dc.description.abstractBackground: 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 groups, and strikingly, trends in mortality and DALY rates from ischemic stroke among younger populations reversed to upward with AAPC over 1.4%. A substantial number of countries contributed to these increasing trends. Interpretation: Regionally, the annual number of stroke cases and deaths significantly increased from 1990 to 2021, despite reductions in age-standardized rates. The declining pace in age-standardized stroke rates has decelerated in recent years, while trends in incidence, and ischemic stroke mortality and DALY among middle-aged adults and adults, reversed towards upward in the period 2015-2021. Further studies are needed to understand the determinants of this recent pattern and identify the most cost-effective interventions to stem this alarming trend. Funding: There was no funding source for this study.
dc.description.versionVersión Publicada
dc.identifier.citationMartinez R, Muñoz-Venturelli P, Ordunez P, Fregni F, Abanto C, Alet M, Alvarez TF, Amaya P, Ameriso S, Arauz A, Barboza MA, Bayona H, Bernabé-Ortiz A, Calleja J, Cano-Nigenda V, Carbonera LA, Carrillo-Larco RM, Corredor A, de Souza AC, Jimenez C, Lanas F, Martins S, Navia V, Novarro-Escudero N, Olavarría V, Ovbiagele B, Pacheco-Barrios K, Pontes-Neto O, Pujol V, Rabinstein A, Rosales J, Rosende A, Sampaio Silva G, Saposnik G, Sen S, Testai FD, Urrutia V, Anderson CS, Lavados PM. 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. Lancet Reg Health Am. 2025 Feb 15;43:101017. doi: 10.1016/j.lana.2025.101017
dc.identifier.doihttps://doi.org/10.1016/j.lana.2025.101017
dc.identifier.urihttps://hdl.handle.net/11447/10964
dc.language.isoen
dc.subjectAmericas
dc.subjectBurden of diseases
dc.subjectIntracerebral hemorrhage
dc.subjectIschemic stroke
dc.subjectStroke
dc.subjectSubarachnoid hemorrhage
dc.titleRisk 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
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceLancet regional health. Americas
dspace.entity.typePublication
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relation.isAuthorOfPublication.latestForDiscovery77bec604-0a16-4d85-aaee-734c326e253a

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