Stroke in Low- and Middle-Income Countries
Increased stroke incidence is largely associated with aging and urbanization and propelled by the increasing prevalence of key risk factors, including history of hypertension, current smoking, diabetes mellitus, waist-to-hip ratio, diet risk score, physical inactivity, alcohol intake, psychosocial stress and depression, cardiac causes, and ratio of apolipoproteins B to A1. Non-modifiable risk factors related to hereditary or natural processes include age, sex/gender, and race/ethnicity. Relative risks, odds ratios, and hazard ratios.
According to World Health Organization (WHO) Global Health Estimates in 2012, stroke was the second leading cause of death and the third leading cause of disability-adjusted life years (DALYs) lost globally. A systematic review that synthesized 12 population-based studies from 10 low- and middle-income countries (LMICs) and 44 studies from 18 high-income countries (HICs) found significant disparities in stroke incidence trends between HICs and LMICs.
Over the past four decades, stroke incidence decreased 42% in HICs, but increased more than 100% in LMICs.
From 2000 to 2008, estimated stroke incidence rates in LMICs surpassed those in HICs by about 20%
Stroke has created heavy social and economic burdens in LMICs
In China in 2004, the average cost for a stroke admission was two times the annual income of rural residents, and the cost of stroke care for the government-funded hospitals increased 117% annually between 2003 and 2007.