Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta-Analysis

Nuñez, Marilaura; Delfino, Carlos; Asenjo, Claudia; Schilling, Andrea; Lavados, Pablo; Anderson, Craig; Munoz Venturelli, Paula

Publication:
Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta-Analysis

dc.contributor.author	Nuñez, Marilaura
dc.contributor.author	Delfino, Carlos
dc.contributor.author	Asenjo, Claudia
dc.contributor.author	Schilling, Andrea
dc.contributor.author	Lavados, Pablo
dc.contributor.author	Anderson, Craig
dc.contributor.author	Munoz Venturelli, Paula
dc.date.accessioned	2024-04-02T19:15:03Z
dc.date.available	2024-04-02T19:15:03Z
dc.date.issued	2023
dc.description.abstract	Background High-income country studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region. Methods and Results A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective population-based observational studies with first-ever stroke incidence in Latin America. Reports without data broken down by age and sex were excluded. Risk of bias was assessed with The Joanna Briggs Institute's guide. The main outcomes were incidence rate ratio and relative temporal trend ratio of SI, comparing time periods before 2010 with after 2010. Pooled relative temporal trend ratios considering only studies with 2 periods in the same population were calculated by random-effects meta-analysis. Meta-regression analysis was used to evaluate incidence rate determinants. From 9242 records identified, 6 studies were selected including 4483 first-ever stroke in 4 101 084 individuals. Crude incidence rate ratio in younger subjects (<55 years) comparing before 2010:after 2010 periods showed an increase in SI in the past decade (incidence rate ratio, 1.37 [95% CI, 1.23-1.50]), in contrast to a decrease in older people during the same period (incidence rate ratio, 0.83 [95% CI, 0.76-0.89]). Overall relative temporal trend ratio (<55:≥55 years) was 1.65 (95 CI%, 1.50-1.80), with higher increase in young women (pooled relative temporal trend ratio, 3.08 [95% CI, 1.18-4.97]; P for heterogeneity <0.001). Conclusions An unfavorable change in SI in young people, especially in women, was detected in population-based studies in the past decade in Latin America and the Caribbean. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision-makers. Registration URL: https://www.crd.york.ac.uk/prospero/ Identifier: CRD42022332563.
dc.description.version	Publicada
dc.identifier.citation	Nuñez M, Delfino C, Asenjo-Lobos C, Schilling A, Lavados P, Anderson CS, Muñoz Venturelli P. Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2023 Sep 5;12(17):e029800. doi: 10.1161/JAHA.123.029800
dc.identifier.doi	https://doi.org/doi: 10.1161/JAHA.123.029800
dc.identifier.uri	https://hdl.handle.net/11447/8582
dc.language.iso	en
dc.subject	Epidemiology
dc.subject	Intracranial hemorrhage
dc.subject	Ischemic stroke
dc.subject	Women
dc.subject	Sex
dc.subject	Gender
dc.title	Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta-Analysis
dc.type	Article
dcterms.accessRights	Acceso Abierto
dcterms.source	Journal of the American Heart Association
dspace.entity.type	Publication
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