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Neuroepidemiology. 2015;45(3):161-76. doi: 10.1159/000441085. Epub 2015 Oct 28.

Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study.

Collaborators (233)

Abera SF, Akinyemi RO, Al-Shahi Salman R, Anderson CS, Bahit MC, Banerjee A, Basu S, Beauchamp NJ, Bornstein NM, Brainin M, Cabral NL, Campos-Nonato I, Caso V, Catalá-López F, Chowdhury R, Christensen HK, Connor MD, DeVeber G, Dharmaratne SD, Dokova K, Donnan G, Endres M, Fernandes JG, Gankpé F, Geleijnse JM, Gillum RF, Giroud M, Hamadeh RR, Hankey GJ, Jeemon P, Jonas JB, Kazi DS, Kengne AP, Kim D, Kissela BM, Kokubo Y, Kosen S, Kravchenko M, Lavados PM, Liu M, Lotufo PA, Mackay MT, Malekzadeh R, Mehndiratta MM, Melaku YA, Misganaw A, Nand D, Piradov M, Pourmalek F, Ricci S, Rojas-Rueda D, Roy N, Sahathevan R, Sampson UK, Shalamov N, Sheth KN, Shinohara Y, Shiue I, Soljak M, Sposato LA, Stroumpoulis K, Tanne D, Thrift AG, Tirschwell DL, Varakin Y, Venketasubramanian N, Vlassov VV, Wang W, Westerman R, Wolfe C, Yu C, Yunjin K, Bahit MC, Thrift AG, Meretoja A, Stavreski B, Anderson CS, Pearse E, Donnan G, Hankey GJ, Mackay MT, Davis S, Ademi Z, Brainin M, Guliyev T, Hamadeh RR, Harewood H, Springer K, Leite Ida C, Fernandes JG, Cabral NL, Lotufo PA, Dokova K, Pourmalek F, deVeber G, Sposato LA, Lindsay MP, Riccio PM, Lavados PM, Li B, Yu C, Jiang G, Ma J, Zhou M, Liu M, Zhu S, Wang W, Liang X, Zhang Y, Alcalá-Cerra G, Christensen HK, Truelsen T, Abd-Allah F, Temesgen A, Sahle BW, Abera SF, Melaku YA, Nand D, Giroud M, Jonas JB, Endres M, Westerman R, Stroumpoulis K, Prabhakaran D, Pandian JD, Mehndiratta MM, Roy N, Jeemon P, Gupta R, Rajagopalan V, Kosen S, Warouw TS, Malekzadeh R, O'Donnell MJ, Tanne D, Bornstein NM, Ricci S, Caso V, Kokubo Y, Shinohara Y, Asad MM, Bwire VK, Jee SH, Khang YH, Yunjin K, Sahathevan R, Campos-Nonato I, Gankpé F, Myint CY, Geleijnse JM, Parmar P, Krishnamurthi RV, Barker-Collo S, Feigin VL, Akinyemi RO, Norheim O, Khalifa SE, Kravchenko M, Piradov M, Shalamov N, Vlassov VV, Varakin Y, Ngirabega Jde D, Nyemazi JP, Muhimpundu MA, Saeedi M, Bedi N, Venketasubramanian N, Kengne AP, Rojas-Rueda D, Catalá-López F, Dharmaratne SD, Norrving B, Havmoeller R, Atwine L, Banerjee A, Wolfe C, Bennett DA, Cundiff DK, O'Callaghan F, Shiue I, Critchley JA, Ezzati M, Soljak M, Connor MD, Rothwell PM, Chowdhury R, Al-Shahi Salman R, Whiteley W, Chen Z, Colomar M, Durrani AM, Dayama A, Moran AE, Misganaw A, Kissela BM, Amlie-Lefond C, Johnson CO, Huang C, Murray CJ, Sumeet C, Kim D, Cundiff DK, Tirschwell DL, Kazi DS, Qato D, Kabagambe EK, Ding E, Bukhman G, Kwan G, Mensah GA, Thurston GD, Nguyen G, Roth GA, Coresh J, Lefondulq K, Sheth KN, Corriere MA, Forouzanfar MH, Naghavi M, Mainoo N, Beauchamp NJ, Sacco RL, Gillum RF, Basu S, Schwartz SM, Chugh S, Fung T, Vos T, Byers TE, Sampson UK, Rocca WA, Lo W.

Author information

National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New.



Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care.


This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013.


Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs).


In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries.


Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority. © 2015 S. Karger AG, Basel.

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