Ischemic Stroke in Europe: Incidence Trends Over Three Decades (1991-2021)
Author(s)
Bettina Kovács, BSc, MSc1, Luca Fanni Kajos, BSc, MSc, PhD2, Dalma Pónusz-Kovács, BSc, MSc1, László Szapáry, MD, PhD3, Eszter Jozifek, BSc, MSc3, Imre Boncz, MSc, PhD, MD2.
1Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary, 2Institute for Health Insurance, University of Pécs, Pécs, Hungary, 3Clinical Centre Department of Neurology, University of Pécs, Pécs, Hungary.
1Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary, 2Institute for Health Insurance, University of Pécs, Pécs, Hungary, 3Clinical Centre Department of Neurology, University of Pécs, Pécs, Hungary.
OBJECTIVES: Stroke is a leading cause of adult disability worldwide. In the early 21st century, age-standardized incidence in Europe ranged from 95 to 290 cases per 100,000 population annually, with around 80% of cases being ischaemic strokes. This study aimed to analyse ischaemic stroke (IS) incidence in Europe over the past three decades (1991-2021), focusing on regional differences and variations by sex and age group.
METHODS: This retrospective, quantitative study used data from the Global Burden of Disease 2021 (GBD 2021) database, accessed via the VizHub platform. Europe was divided into three regions based on GBD classification: Central Europe (CE, 13 countries), Eastern Europe (EE, 7 countries), and Western Europe (WE, 24 countries), covering a total of 44 countries. Data processing and analysis were conducted using MS Excel 2016 and IBM SPSS 25.0. Descriptive statistics were complemented with time series analysis and the Kruskal-Wallis test (p<0.05), followed by pairwise comparisons to assess regional differences.
RESULTS: From 1991 to 2021, a significant difference in age-specific IS incidence trends was observed between WE and CE, and between WE and EE (p<0.05), while CE and EE showed no significant difference (p>0.05). The largest decrease occurred in WE (men: -44.6%, women: -45.05%), followed by CE (men: -24.4%, women: -32.39%) and EE (men: -26.8%, women: -28.02%). By 2021, WE had the lowest, and EE the highest incidence. Across the EU, the average decline was 55.8% in men and 43.6% in women. Portugal showed the greatest improvement in both sexes (men: -122.65%, women: -99.59%), while some Western European countries (e.g., France) showed minimal change or stagnation.
CONCLUSIONS: The declining IS incidence in Europe suggests improvements in cardiovascular prevention, risk factor management, and healthcare delivery. However, EE still faces a high burden, highlighting the need for targeted public health interventions.
METHODS: This retrospective, quantitative study used data from the Global Burden of Disease 2021 (GBD 2021) database, accessed via the VizHub platform. Europe was divided into three regions based on GBD classification: Central Europe (CE, 13 countries), Eastern Europe (EE, 7 countries), and Western Europe (WE, 24 countries), covering a total of 44 countries. Data processing and analysis were conducted using MS Excel 2016 and IBM SPSS 25.0. Descriptive statistics were complemented with time series analysis and the Kruskal-Wallis test (p<0.05), followed by pairwise comparisons to assess regional differences.
RESULTS: From 1991 to 2021, a significant difference in age-specific IS incidence trends was observed between WE and CE, and between WE and EE (p<0.05), while CE and EE showed no significant difference (p>0.05). The largest decrease occurred in WE (men: -44.6%, women: -45.05%), followed by CE (men: -24.4%, women: -32.39%) and EE (men: -26.8%, women: -28.02%). By 2021, WE had the lowest, and EE the highest incidence. Across the EU, the average decline was 55.8% in men and 43.6% in women. Portugal showed the greatest improvement in both sexes (men: -122.65%, women: -99.59%), while some Western European countries (e.g., France) showed minimal change or stagnation.
CONCLUSIONS: The declining IS incidence in Europe suggests improvements in cardiovascular prevention, risk factor management, and healthcare delivery. However, EE still faces a high burden, highlighting the need for targeted public health interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH152
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)