Burden of Stroke in Europe: An Analysis of the Global Burden of Disease Study Findings From 2010 to 2019
Authors: Prendes Carlota F. , Rantner Barbara , Hamwi Tarek , Stana Jan , Feigin Valery L. , Stavroulakis Konstantinos , Tsilimparis Nikolaos , Fernandez Prendes Carlota , Rantner Barbara , Hamwi Tarek , Stana Jan , Feigin Prof Valery L , Stavroulakis Konstantinos , Tsilimparis Nikolaos , Aboyans Prof Victor , Olusola Akinyemi Rufus , Al-Shahi Salman Prof Rustam , Artamonov Anton A , Aujayeb Avinash , Baldereschi Marzia , Basu Sanjay , Béjot Prof Yannick , Belo Luis , Bennett Derrick A , Srikanth Bhagavathula Akshaya , Bikbov Boris , Brenner Prof Hermann , Luciano Caetano dos Santos Florentino , Carrero Prof Juan J , Carvalho Prof Felix , Catapano Prof Alberico L , Charalampous Periklis , Christensen Prof Hanne , Chung Sheng-Chia , Angelo Cortesi Paolo , Marisa Costa Vera , Cyganska Malgorzata , D’Amico Emanuele , Davletov Kairat , Georgieva Dokova Klara , Douiri Abdel , Francis Fagbamigbe Adeniyi , Fischer Florian , Ghith Nermin , Giampaoli Simona , Singh Gill Prof Paramjit , Gnedovskaya Elena V , Havmoeller Rasmus J , Hostiuc Sorin , Iavicoli Prof Ivo , Ilic Prof Milena D , Isola Prof Gaetano , Jerzy Jozwiak Jacek , Jürisson Mikk , Kayode Gbenga A , Khan Moien AB , Khatab Prof Khaled , Kisa Prof Adnan , Kivimäki Prof Mika , Koyanagi Ai , Kulimbet Mukhtar , Kusuma Dian , La Vecchia Prof Carlo , Lacey Ben , Lallukka Prof Tea , Lorkowski Prof Stefan , Majeed Prof Azeem , Giovanni Mantovani Prof Lorenzo , Mazzaglia Giampiero , Mentis Alexios-Fotios A , Meretoja Atte , Miao Jonasson Junmei , Mirica Andreea , Mirrakhimov Prof Erkin M , Mohammed Shafiu , Molokhia Mariam , Monasta Lorenzo , Mons Prof Ute , Morze Jakub , Irina Negoi Ruxandra , Norrving Prof Bo , Oancea Prof Bogdan , O’Caoimh Rónán , Orru Hans , Padron-Monedero Alicia , Pedersini Paolo , Perico Norberto , Polibin Roman V , Polinder Suzanne , Raggi Alberto , Rawaf Prof Salman , Remuzzi Prof Giuseppe , Romoli Michele , Sacco Prof Simona , Reza Saeb Prof Mohammad , Vasco Santos João , Santric-Milicevic Prof Milena M , Aleksandrovna Skryabina Anna , Smith Lee , Starodubova Antonina V , Stevanović Aleksandar , Stranges Prof Saverio , Teuschl Yvonne , Topor-Madry Roman , Touvier Mathilde , Tovani-Palone Marcos Roberto , Unim Brigid , Juhani Vasankari Prof Tommi , Volovici Victor , Wafa Hatem A , Wang Yanzhong , Westerman Ronny , Wolfe Prof Charles D A , Yesiltepe Metin , Zanghì Aurora , Sergeevich Zastrozhin Prof Mikhail 
Published: January 2024

BACKGROUND:
While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010.

METHODS:
The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disability-adjusted life years of stroke for the European Region as defined by the World Health Organization, with its 53 member countries (EU-53) and for European Union as defined in 2019, with its 28 member countries (EU-28), between 2010 and 2019. Results were analyzed at a regional, subregional, and country level.

RESULTS:
In EU-53, the absolute number of incident and prevalent strokes increased by 2% (uncertainty interval [UI], 0%–4%), from 1 767 280 to 1 802 559 new cases, and by 4% (UI, 3%–5%) between 2010 and 2019, respectively. In EU-28, the absolute number of prevalent strokes and stroke-related deaths increased by 4% (UI, 2%–5%) and by 6% (UI, 1%–10%), respectively. All-stroke age-standardized mortality rates, however, decreased by 18% (UI, −22% to −14%), from 82 to 67 per 100 000 people in the EU-53, and by 15% (UI, −18% to −11%), from 49.3 to 42.0 per 100 000 people in EU-28. Despite most countries presenting reductions in age-adjusted incidence, prevalence, mortality, and disability-adjusted life year rates, these rates remained 1.4×, 1.2×, 1.6×, and 1.7× higher in EU-53 in comparison to the EU-28.

CONCLUSIONS:
EU-53 showed a 2% increase in incident strokes, while they remained stable in EU-28. Age-standardized rates were consistently lower for all-stroke burden parameters in EU-28 in comparison to EU-53, and huge discrepancies in incidence, prevalence, mortality, and disability-adjusted life-year rates were observed between individual countries.