Epidemiology

Stroke is the second leading cause of death and a major cause of disability worldwide.[9]​ In 2019, a total of 3.29 million people died worldwide as a result of ischemic stroke.[9]​​

There are approximately 795,000 new and recurrent strokes per year in the US, where it is the fifth leading cause of death and a major cause of disability.[10]​​ Ischemic stroke accounts for 87% of all stroke cases in the US, hemorrhagic stroke for 10%, and subarachnoid hemorrhage for 3%.[10]​​ Ischemic stroke prevalence can be further subdivided according to pathophysiologic mechanism: extracranial atherosclerosis (10%), intracranial atherosclerosis (10%), cardioembolic (25%), lacunar infarction ([small vessel disease] 15%), undetermined etiology ([i.e., cryptogenic; embolic stroke of unknown source] 30%), or other defined causes (10%).

Overall, ischemic stroke is more common in older people, males, people with lower levels of education, and African-American and Latino/Hispanic people.[11]​​[12]​​[13]​​[14]​​[15] However, rates of cerebral venous thrombosis are highest in younger women, with both oral contraception and pregnancy/puerperium being major risk factors.[8][16][17]​​​

Both the overall age-standardized incidence of stroke and stroke mortality have been decreasing over the last few decades in high-income countries, presumably due to effective primary prevention and improved management during the acute phase of stroke, although there is some evidence of increasing incidence among young adults.​[10][18][19][20]​​​​​​​ In contrast, stroke incidence and mortality in low- and middle-income countries has increased.[21]​​[22][23]​​​​​ In 2019, the age-standardized stroke-related mortality rate was 3.6 times higher in the World Bank low-income group than in the World Bank high-income group.[9]​ In 2021, Oceania and Southeast and Central Asia had the highest rates of overall stroke mortality.[9]​ Stroke is the leading cause of death in China.[22]

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