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Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019 Publisher Pubmed



Feigin VL1, 2, 9 ; Stark BA2 ; Johnson CO2 ; Roth GA2, 3, 4 ; Bisignano C2 ; Abady GG10 ; Abbasifard M11, 12 ; Abbasikangevari M16 ; Abdallah F19 ; Abedi V20, 22 ; Abualhasan A19 ; Aburmeileh NME23 ; Abushouk AI24, 33 ; Adebayo OM36 Show All Authors
Authors
  1. Feigin VL1, 2, 9
  2. Stark BA2
  3. Johnson CO2
  4. Roth GA2, 3, 4
  5. Bisignano C2
  6. Abady GG10
  7. Abbasifard M11, 12
  8. Abbasikangevari M16
  9. Abdallah F19
  10. Abedi V20, 22
  11. Abualhasan A19
  12. Aburmeileh NME23
  13. Abushouk AI24, 33
  14. Adebayo OM36
  15. Agarwal G39
  16. Agasthi P41
  17. Ahinkorah BO42
  18. Ahmad S44
  19. Ahmadi S17
  20. Salih YA45, 46
  21. Aji B47
  22. Akbarpour S48
  23. Akinyemi RO55, 61
  24. Al Hamad H62, 63
  25. Alahdab F64
  26. Alif SM65
  27. Alipour V71, 72
  28. Aljunid SM77, 499
  29. Almustanyir S78, 79
  30. Alraddadi RM80
  31. Salman RAS82
  32. Alvisguzman N84, 85
  33. Ancuceanu R86
  34. Anderlini D89, 90
  35. Anderson JA2
  36. Ansar A91, 92
  37. Antonazzo IC93
  38. Arabloo J71
  39. Arnlov J96, 99
  40. Artanti KD100
  41. Aryan Z25, 49
  42. Asgari S18
  43. Ashraf T102
  44. Athar M105, 106
  45. Atreya A107
  46. Ausloos M108, 109
  47. Baig AA110
  48. Baltatu OC111, 112
  49. Banach M113, 114
  50. Barboza MA115, 116
  51. Barkercollo SL117
  52. Barnighausen TW26, 118
  53. Barone MTU120, 121
  54. Basu S27, 122
  55. Bazmandegan G11, 12
  56. Beghi E126
  57. Beheshti M127
  58. Bejot Y128, 129
  59. Bell AW28, 130
  60. Bennett DA131
  61. Bensenor IM132
  62. Bezabhe WM135, 138
  63. Bezabih YM136, 139
  64. Bhagavathula AS140, 141
  65. Bhardwaj P143, 144
  66. Bhattacharyya K147, 148
  67. Bijani A149
  68. Bikbov B150
  69. Birhanu MM151, 152
  70. Boloor A153
  71. Bonny A156, 500
  72. Brauer M2, 501
  73. Brenner H502
  74. Bryazka D2
  75. Butt ZA503, 504
  76. Dos Santos FLC505
  77. Camposnonato IR506
  78. Cantubrito C508
  79. Carrero JJ97
  80. Castanedaorjuela CA157, 442
  81. Catapano AL158, 160
  82. Chakraborty PA501
  83. Charan J145
  84. Choudhari SG161
  85. Chowdhury EK66, 164
  86. Chu DT165
  87. Chung SC166, 168
  88. Colozza D169, 172
  89. Costa VM173
  90. Costanzo S174
  91. Criqui MH175
  92. Dadras O176, 177
  93. Dagnew B178
  94. Dai X2
  95. Dalal K180, 181
  96. Damasceno AAM183
  97. Damico E184
  98. Dandona L2, 186, 187
  99. Dandona R2, 4, 186
  100. Gela JD188
  101. Davletov K182
  102. De La Cruzgongora V507
  103. Desai R189
  104. Dhamnetiya D190
  105. Dharmaratne SD2, 4, 191
  106. Dhimal ML192, 193
  107. Dhimal M194
  108. Diaz D196, 197
  109. Dichgans M198
  110. Dokova K199
  111. Doshi R200
  112. Douiri A170
  113. Duncan BB201
  114. Eftekharzadeh S202
  115. Ekholuenetale M56, 57
  116. El Nahas N34
  117. Elgendy IY29, 204
  118. Elhadi M205
  119. Eljaafary SI19
  120. Endres M206
  121. Endries AY207
  122. Erku DA208
  123. Faraon EJA209
  124. Farooque U210
  125. Farzadfar F49
  126. Feroze AH5, 211
  127. Filip I212, 213
  128. Fischer F214
  129. Flood D215, 216
  130. Gad MM217, 220
  131. Gaidhane S162
  132. Gheshlagh RG221
  133. Ghashghaee A71, 73
  134. Ghith N222
  135. Ghozali G223
  136. Ghozy S224
  137. Gialluisi A174
  138. Giampaoli S225
  139. Gilani SA103, 226
  140. Gill PS227
  141. Gnedovskaya EV8
  142. Golechha M228
  143. Goulart AC132, 133
  144. Guo Y67, 229
  145. Gupta R230, 231
  146. Gupta VB232
  147. Gupta VK233
  148. Gyanwali P195, 234
  149. Hafezinejad N50, 235
  150. Hamidi S238
  151. Hanif A104
  152. Hankey GJ239, 241
  153. Hargono A100
  154. Hashi A242
  155. Hassan TS98, 243
  156. Hassen HY244, 245
  157. Havmoeller RJ246
  158. Hay SI2, 4
  159. Hayat K247, 248
  160. Hegazy MI19
  161. Herteliu C109, 249
  162. Holla R250
  163. Hostiuc S87, 253
  164. Househ M254
  165. Huang J255
  166. Humayun A256
  167. Hwang BF257
  168. Iacoviello L174, 259
  169. Iavicoli I260
  170. Ibitoye SE58
  171. Ilesanmi OS37, 59
  172. Ilic IM261
  173. Ilic MD263
  174. Iqbal U264
  175. Irvani SSN265
  176. Islam SMS266, 267
  177. Ismail NE269
  178. Iso H271
  179. Isola G185
  180. Iwagami M272, 274
  181. Jacob L275, 276
  182. Jain V218
  183. Jang SI277
  184. Jayapal SK278
  185. Jayaram S279
  186. Jayawardena R280, 281, 282
  187. Jeemon P284
  188. Jha RP190, 285
  189. Johnson WD286
  190. Jonas JB119, 287
  191. Joseph N154
  192. Jozwiak JJ288
  193. Jurisson M289
  194. Kalani R6
  195. Kalhor R290, 291
  196. Kalkonde Y292
  197. Kamath A250, 252
  198. Kamiab Z12, 13
  199. Kanchan T146
  200. Kandel H268, 293
  201. Karch A294
  202. Katoto PDMC295, 296
  203. Kayode GA297, 298
  204. Keshavarz P299, 300
  205. Khader YS301
  206. Khan EA302
  207. Khan IA303
  208. Khan M304
  209. Khan MAB142, 305
  210. Khatib MN163
  211. Khubchandani J306
  212. Kim GR307
  213. Kim MS309, 310
  214. Kim YJ311
  215. Kisa A312, 313
  216. Kisa S314
  217. Kivimaki M167, 315
  218. Kolte D30, 204
  219. Koolivand A316
  220. Laxminarayana SLK318
  221. Koyanagi A319, 320
  222. Krishan K321
  223. Krishnamoorthy V7, 322
  224. Krishnamurthi RV1
  225. Kumar GA186
  226. Kusuma D123, 323
  227. Vecchia CL159
  228. Lacey B131, 324
  229. Lak HM218
  230. Lallukka T315
  231. Lasrado S325
  232. Lavados PM326, 327
  233. Leonardi M328
  234. Li B329
  235. Li S68
  236. Lin H330
  237. Lin RT258, 331
  238. Liu X219, 332
  239. Lo WD333, 334
  240. Lorkowski S335, 336
  241. Lucchetti G337
  242. Saute RL338
  243. Abd El Razek HM340
  244. Magnani FG328
  245. Mahajan PB341
  246. Majeed A124
  247. Makki A342
  248. Malekzadeh R51, 343
  249. Malik AA81, 104
  250. Manafi N74, 345
  251. Mansournia MA52
  252. Mantovani LG94, 346
  253. Martini S101, 347
  254. Mazzaglia G95
  255. Mehndiratta MM348, 349
  256. Menezes RG350
  257. Meretoja A351, 352
  258. Mersha AG179, 354
  259. Jonasson JM355
  260. Miazgowski B356, 358
  261. Miazgowski T357
  262. Michalek IM359
  263. Mirrakhimov EM360, 361
  264. Mohammad Y362
  265. Mohammadianhafshejani A365
  266. Mohammed S366, 367
  267. Mokdad AH2, 4
  268. Mokhayeri Y368
  269. Molokhia M171
  270. Moni MA369
  271. Al Montasir A370, 371
  272. Moradzadeh R317
  273. Morawska L283
  274. Morze J372
  275. Muruet W170
  276. Musa KI373
  277. Nagarajan AJ374, 375
  278. Naghavi M2, 4
  279. Swamy SN376
  280. Nascimento BR377, 378
  281. Negoi RI88, 379
  282. Kandel SN380
  283. Nguyen TH381, 382
  284. Norrving B383
  285. Noubiap JJ384
  286. Nwatah VE387, 388
  287. Oancea B389
  288. Odukoya OO390, 391
  289. Olagunju AT40, 392
  290. Orru H289, 393
  291. Owolabi MO38, 60
  292. Padubidri JR250
  293. Pana A109, 394
  294. Parekh T395
  295. Park EC307, 308
  296. Kan FP76
  297. Pathak M396
  298. Peres MFP134, 397
  299. Perianayagam A398
  300. Pham TM399
  301. Piradov MA9
  302. Podder V385, 400
  303. Polinder S401
  304. Postma MJ402, 403, 404
  305. Pourshams A51
  306. Radfar A405
  307. Rafiei A406, 407
  308. Raggi A328
  309. Rahim F53, 408
  310. Rahimimovaghar V54
  311. Rahman M91, 409, 410
  312. Rahman MA409
  313. Rahmani AM411
  314. Rajai N31
  315. Ranasinghe P281
  316. Rao CR251
  317. Rao SJ412
  318. Rathi P250
  319. Rawaf DL124, 125, 413
  320. Rawaf S414
  321. Reitsma MB2
  322. Renjith V415
  323. Renzaho AMN416, 417
  324. Rezapour A71
  325. Rodriguez JAB418
  326. Roever L419
  327. Romoli M420, 421
  328. Rynkiewicz A422
  329. Sacco S423
  330. Sadeghi M424
  331. Moghaddam SS49
  332. Sahebkar A426, 427
  333. Saifurrahman KM428, 430
  334. Salah R431, 432
  335. Samaei M433
  336. Samy AM35
  337. Santos IS132, 133
  338. Santricmilicevic MM261, 262
  339. Sarrafzadegan N425, 501
  340. Sathian B62, 434
  341. Sattin D328
  342. Schiavolin S328
  343. Schlaich MP240, 435
  344. Schmidt MI201
  345. Schutte AE436, 440
  346. Sepanlou SG51, 343
  347. Seylani A441
  348. Sha F443
  349. Shahabi S344
  350. Shaikh MA444
  351. Shannawaz M445
  352. Shawon MDSR437
  353. Sheikh A32, 83
  354. Sheikhbahaei S235
  355. Shibuya K446
  356. Siabani S43, 447
  357. Silva DAS448
  358. Singh JA449, 450
  359. Singh JK451
  360. Skryabin VY452
  361. Skryabina AA454
  362. Sobaih BH363, 455
  363. Stortecky S456
  364. Stranges S457, 458
  365. Tadesse EG459
  366. Tarigan IU460
  367. Temsah MH364
  368. Teuschl Y461
  369. Thrift AG69
  370. Tonelli M462
  371. Tovanipalone MR339, 463
  372. Tran BX464
  373. Tripathi M465
  374. Tsegaye GW137
  375. Ullah A466
  376. Unim B467
  377. Unnikrishnan B155
  378. Vakilian A14, 15
  379. Tahbaz SV468, 509
  380. Vasankari TJ469
  381. Venketasubramanian N470, 471
  382. Vervoort D236
  383. Vo B472
  384. Volovici V402, 473
  385. Vosoughi K75, 237
  386. Vu GT474
  387. Vu LG381, 382
  388. Wafa HA170
  389. Waheed Y475
  390. Wang Y170
  391. Wijeratne T353, 476
  392. Winkler AS477, 478
  393. Wolfe CDA170, 479
  394. Woodward M480, 481
  395. Wu JH482
  396. Hanson SW2
  397. Xu X438, 439
  398. Yadav L386, 483
  399. Yadollahpour A484
  400. Jabbari SHY509
  401. Yamagishi K270, 273
  402. Yatsuya H430, 485
  403. Yonemoto N486, 487
  404. Yu C488
  405. Yunusa I26, 490
  406. Zaman MS491
  407. Zaman SB70, 429
  408. Zamanian M317
  409. Zand R21, 492
  410. Zandifar A203
  411. Zastrozhin MS453, 493
  412. Zastrozhina A494
  413. Zhang Y495, 496
  414. Zhang ZJ489
  415. Zhong C255
  416. Zuniga YMH497, 498
  417. Murray CJL2, 4
Show Affiliations
Authors Affiliations
  1. 1. National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
  2. 2. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  3. 3. Division of Cardiology, University of Washington, Seattle, WA, United States
  4. 4. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  5. 5. Department of Neurological Surgery, University of Washington, Seattle, WA, United States
  6. 6. Department of Neurology, University of Washington, Seattle, WA, United States
  7. 7. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
  8. 8. Third Department of Neurology, Moscow, Russian Federation
  9. 9. Research Center of Neurology, Moscow, Russian Federation
  10. 10. Department of Nursing, Adigrat University, Adigrat, Ethiopia
  11. 11. Department of Internal Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  12. 12. Clinical Research Development Unit, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  13. 13. Family Medicine Department, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  14. 14. Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  15. 15. Non-communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  16. 16. Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  17. 17. School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  18. 18. Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  19. 19. Department of Neurology, Cairo University, Cairo, Egypt
  20. 20. Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, United States
  21. 21. Department of Neuroscience, Geisinger Health System, Danville, PA, United States
  22. 22. Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
  23. 23. Institute of Community and Public Health, Birzeit University, Ramallah, Palestine
  24. 24. Harvard Medical School, Harvard University, Boston, MA, United States
  25. 25. Brigham and Women's Hospital, Harvard University, Boston, MA, United States
  26. 26. TH Chan School of Public Health, Harvard University, Boston, MA, United States
  27. 27. Center for Primary Care, Harvard University, Boston, MA, United States
  28. 28. Department of Global Health and Social Medicine, Harvard University, Boston, MA, United States
  29. 29. Division of Cardiology, Harvard University, Boston, MA, United States
  30. 30. Department of Medicine, Harvard University, Boston, MA, United States
  31. 31. Department of Internal Medicine, Harvard University, Boston, MA, United States
  32. 32. Division of General Internal Medicine, Harvard University, Boston, MA, United States
  33. 33. Department of Medicine, Ain Shams University, Cairo, Egypt
  34. 34. Neurology Department, Ain Shams University, Cairo, Egypt
  35. 35. Department of Entomology, Ain Shams University, Cairo, Egypt
  36. 36. College of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
  37. 37. Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
  38. 38. Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
  39. 39. Department of Family Medicine, McMaster University, Hamilton, ON, Canada
  40. 40. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
  41. 41. Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ, United States
  42. 42. The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia
  43. 43. School of Health, University of Technology Sydney, Sydney, NSW, Australia
  44. 44. Faculty of Pharmacy, MAHSA University, Kuala Langat, Malaysia
  45. 45. Database Technology Department, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
  46. 46. College of Informatics, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
  47. 47. Faculty of Medicine and Public Health, Jenderal Soedirman University, Purwokerto, Indonesia
  48. 48. Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
  49. 49. Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  50. 50. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  51. 51. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  52. 52. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
  53. 53. Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
  54. 54. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  55. 55. Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
  56. 56. Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
  57. 57. Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
  58. 58. Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
  59. 59. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  60. 60. Department of Medicine, University of Ibadan, Ibadan, Nigeria
  61. 61. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
  62. 62. Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
  63. 63. Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
  64. 64. Mayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  65. 65. Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  66. 66. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
  67. 67. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  68. 68. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  69. 69. Department of Medicine, Monash University, Melbourne, VIC, Australia
  70. 70. The School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
  71. 71. Health Management and Economics Research Center, Tehran, Iran
  72. 72. Department of Health Economics, Tehran, Iran
  73. 73. Student Research Committee, Tehran, Iran
  74. 74. School of Medicine, Tehran, Iran
  75. 75. Preventive Medicine and Public Health Research Center, Tehran, Iran
  76. 76. Iran University of Medical Sciences, Tehran, Iran
  77. 77. International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
  78. 78. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  79. 79. Ministry of Health, Riyadh, Saudi Arabia
  80. 80. Department of Community Medicine
  81. 81. Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  82. 82. Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
  83. 83. Centre for Medical Informatics, University of Edinburgh, Edinburgh, United Kingdom
  84. 84. Research Group in Hospital Management and Health Policies, Universidad de la Costa (University of the Coast), Barranquilla, Colombia
  85. 85. Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
  86. 86. Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  87. 87. Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  88. 88. Department of Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  89. 89. Centre for Sensorimotor Performance, The University of Queensland, Brisbane, QLD, Australia
  90. 90. Neurology Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
  91. 91. School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
  92. 92. Special Interest Group International Health, Public Health Association of Australia, Canberra, ACT, Australia
  93. 93. Research Center on Public Health, University of Milan Bicocca, Monza, Italy
  94. 94. School of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
  95. 95. Department of Medicine, University of Milan Bicocca, Monza, Italy
  96. 96. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
  97. 97. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
  98. 98. Department of Medicine, Karolinska Institute, Stockholm, Sweden
  99. 99. School of Health and Social Studies, Dalarna University, Falun, Sweden
  100. 100. Department of Epidemiology, Universitas Airlangga (Airlangga University), Surabaya, Indonesia
  101. 101. Faculty of Public Health, Universitas Airlangga (Airlangga University), Surabaya, Indonesia
  102. 102. University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
  103. 103. Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
  104. 104. University Institute of Public Health, The University of Lahore, Lahore, Pakistan
  105. 105. Department of Medical Genetics, Umm Al-Qura University, Makkah, Saudi Arabia
  106. 106. Science and Technology Unit, Umm Al-Qura University, Makkah, Saudi Arabia
  107. 107. Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
  108. 108. School of Business, University of Leicester, Leicester, United Kingdom
  109. 109. Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
  110. 110. Unit of Biochemistry, Universiti Sultan Zainal Abidin (Sultan Zainal Abidin University), Kuala Terengganu, Malaysia
  111. 111. Department of Pharmacology and Therapeutics, Khalifa University, Abu Dhabi, United Arab Emirates
  112. 112. Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, Sao Jose dos Campos, Brazil
  113. 113. Department of Hypertension, Medical University of Lodz, Lodz, Poland
  114. 114. Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
  115. 115. Department of Neurosciences, Costa Rican Department of Social Security, San Jose, Costa Rica
  116. 116. School of Medicine, University of Costa Rica, San Pedro, Costa Rica
  117. 117. School of Psychology, University of Auckland, Auckland, New Zealand
  118. 118. Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
  119. 119. Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
  120. 120. Programs, Partnerships, Research and Education, International Diabetes Federation, Sao Paulo, Brazil
  121. 121. International Diabetes Federation, Brussels, Belgium
  122. 122. School of Public Health, Imperial College London, London, United Kingdom
  123. 123. Imperial College Business School, Imperial College London, London, United Kingdom
  124. 124. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  125. 125. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  126. 126. Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
  127. 127. Department of Physical Medicine and Rehabilitation, New York University, New York, NY, United States
  128. 128. Department of Neurology, University Hospital of Dijon, Dijon, France
  129. 129. Dijon Stroke Registry - UFR Sciences Sante, University of Burgundy, Dijon, France
  130. 130. Department of Social Services, Tufts Medical Center, Boston, MA, United States
  131. 131. Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  132. 132. Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil
  133. 133. Center for Clinical and Epidemiological Research, University of Sao Paulo, Sao Paulo, Brazil
  134. 134. Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
  135. 135. University of Tasmania, Tasmania, VIC, Australia
  136. 136. Department of Internal Medicine, Bahir Dar, Ethiopia
  137. 137. College of Medicine and Health Sciences, Bahir Dar, Ethiopia
  138. 138. Bahir Dar University, Bahir Dar, Ethiopia
  139. 139. One Health, University of Nantes, Nantes, France
  140. 140. Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
  141. 141. Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
  142. 142. Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
  143. 143. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
  144. 144. School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
  145. 145. Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
  146. 146. Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
  147. 147. Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
  148. 148. Department of Statistics, University of Calcutta, Kolkata, India
  149. 149. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  150. 150. Mario Negri Institute for Pharmacological Research, Ranica, Italy
  151. 151. Stroke and Ageing Research Group, Epidemiology and Prevention Division, Monash University, Clayton, Melbourne, Australia
  152. 152. Department of Nursing, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
  153. 153. Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
  154. 154. Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
  155. 155. Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  156. 156. Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
  157. 157. Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
  158. 158. Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
  159. 159. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  160. 160. MultiMedica, IRCCS, Sesto S. Giovanni, Italy
  161. 161. Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
  162. 162. Department of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
  163. 163. Global Evidence Synthesis Initiative, Datta Meghe Institute of Medical Sciences, Wardha, India
  164. 164. School of Public Health, Curtin University, Perth, WA, Australia
  165. 165. Center for Biomedicine and Community Health, VNU-International School, Hanoi, Viet Nam
  166. 166. Department of Health Informatics, University College London, London, United Kingdom
  167. 167. Department of Epidemiology and Public Health, University College London, London, United Kingdom
  168. 168. Health Data Research UK, London, United Kingdom
  169. 169. Department of Global Health and Social Medicine, King's College London, London, United Kingdom
  170. 170. School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
  171. 171. Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
  172. 172. Office of Climate Change, Biodiversity and Environment, Food and Agriculture Organization of the United Nations, Rome, Italy
  173. 173. Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
  174. 174. Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
  175. 175. Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States
  176. 176. School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
  177. 177. Graduate School of Medicine, Kyoto University, Kyoto, Japan
  178. 178. Department of Human Physiology, University of Gondar, Gondar, Ethiopia
  179. 179. School of Medicine, University of Gondar, Gondar, Ethiopia
  180. 180. Division of Public Health Science, Mid Sweden University, Sundsvall, Sweden
  181. 181. Higher School of Public Health, Al Farabi Kazakh National University, Almaty, Kazakhstan
  182. 182. Health Research Institute, Al Farabi Kazakh National University, Almaty, Kazakhstan
  183. 183. Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
  184. 184. Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
  185. 185. Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
  186. 186. Public Health Foundation of India, Gurugram, India
  187. 187. Indian Council of Medical Research, New Delhi, India
  188. 188. Department of Public Health, Ambo University, Ambo, Ethiopia
  189. 189. Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
  190. 190. Department of Community Medicine, Dr Baba Sahib Ambedkar Medical College and Hospital, Delhi, India
  191. 191. Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  192. 192. Policy Research Institute, Kathmandu, Nepal
  193. 193. Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
  194. 194. Health Research Section, Kathmandu, Nepal
  195. 195. Nepal Health Research Council, Kathmandu, Nepal
  196. 196. Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
  197. 197. Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacan Rosales, Mexico
  198. 198. Institute for Stroke and Dementia Research, Ludwig Maximilians University, Munich, Germany
  199. 199. Department of Social Medicine and Health Care Organisation, Medical University of Varna, Varna, Bulgaria
  200. 200. Department of Internal Medicine, University of Nevada Reno, Reno, NV, United States
  201. 201. Postgraduate Program in Epidemiology, Federal University of Rio Grande Do sul, Porto Alegre, Brazil
  202. 202. Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
  203. 203. Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
  204. 204. Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States
  205. 205. Faculty of Medicine, University of Tripoli, Tripoli, Libya
  206. 206. Department of Neurology, Charite University Medical Center Berlin, Berlin, Germany
  207. 207. Public Health Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
  208. 208. Centre for Applied Health Economics, Griffith University, Gold Coast, QLD, Australia
  209. 209. Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
  210. 210. Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
  211. 211. Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
  212. 212. Psychiatry Department, Kaiser Permanente, Fontana, CA, United States
  213. 213. School of Health Sciences, AT Still University, Mesa, AZ, United States
  214. 214. Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
  215. 215. Center for Research in Indigenous Health, Maya Health Alliance, Tecpan, Guatemala
  216. 216. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
  217. 217. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
  218. 218. Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
  219. 219. Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
  220. 220. Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
  221. 221. Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
  222. 222. Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
  223. 223. Department of Public Health, University of Muhammadiyah Kalimantan Timur, Samarinda, Indonesia
  224. 224. Neurosurgery Department, Mansoura University, Mansoura, Egypt
  225. 225. Department of Cardiovascular Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanita, Rome, Italy
  226. 226. Afro-Asian Institute, Lahore, Pakistan
  227. 227. Medical School, University of Warwick, Coventry, United Kingdom
  228. 228. Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
  229. 229. Department of Epidemiology, Binzhou Medical University, Yantai City, China
  230. 230. Department of Preventive Cardiology, Eternal Heart Care Centre and Research Institute, Jaipur, India
  231. 231. Department of Medicine, Mahatma Gandhi University Medical Sciences, Jaipur, India
  232. 232. School of Medicine, Deakin University, Geelong, VIC, Australia
  233. 233. Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
  234. 234. Department of Clinical Pharmacology, Tribhuvan University, Kathmandu, Nepal
  235. 235. Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States
  236. 236. Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States
  237. 237. Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, United States
  238. 238. School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  239. 239. Medical School, University of Western Australia, Perth, WA, Australia
  240. 240. Dobney Hypertension Centre, University of Western Australia, Perth, WA, Australia
  241. 241. Department of Neurology, Sir Charles Gairdner Hospital, Perth, WA, Australia
  242. 242. Department of Public Health, Jigjiga University, Jijiga, Ethiopia
  243. 243. Research Centre, Salahaddin University, Erbil, Iraq
  244. 244. Department of Primary and Interdisciplinary Care, University Hospital Antwerp, Antwerp, Belgium
  245. 245. Department of Public Health, Mizan-Tepi University, Mizan Teferi, Ethiopia
  246. 246. Skaane University Hospital, Skaane County Council, Malmoe, Sweden
  247. 247. Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
  248. 248. Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
  249. 249. School of Business, London South Bank University, London, United Kingdom
  250. 250. Kasturba Medical College, Mangalore, India
  251. 251. Department of Community Medicine, Manipal, India
  252. 252. Manipal Academy of Higher Education, Manipal, India
  253. 253. Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
  254. 254. College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
  255. 255. Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
  256. 256. Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Lahore, Pakistan
  257. 257. Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
  258. 258. College of Public Health, China Medical University, Taichung, Taiwan
  259. 259. Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
  260. 260. Department of Public Health, University of Naples Federico II, Naples, Italy
  261. 261. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  262. 262. School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
  263. 263. Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
  264. 264. College of Public Health, Taipei Medical University, Taipei, Taiwan
  265. 265. Tabriz, Iran
  266. 266. Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
  267. 267. Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  268. 268. Save Sight Institute, University of Sydney, Sydney, NSW, Australia
  269. 269. Department of Clinical Pharmacy, MAHSA University, Bandar Saujana Putra, Malaysia
  270. 270. Graduate School of Medicine, Osaka University, Suita, Japan
  271. 271. Public Health Department of Social Medicine, Osaka University, Suita, Japan
  272. 272. Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
  273. 273. Research and Development Center for Health Services, University of Tsukuba, Tsukuba, Japan
  274. 274. Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  275. 275. Research and Development Unit, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Sant Boi de Llobregat, Spain
  276. 276. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
  277. 277. Department of Preventive Medicine, Yonsei University, Seodaemun-gu, South Korea
  278. 278. Centre of Studies and Research, Ministry of Health, Muscat, Oman
  279. 279. Department of Biochemistry, Government Medical College, Mysuru, India
  280. 280. Department of Physiology, University of Colombo, Colombo, Sri Lanka
  281. 281. Department of Pharmacology, University of Colombo, Colombo, Sri Lanka
  282. 282. School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
  283. 283. International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
  284. 284. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  285. 285. Department of Community Medicine, Banaras Hindu University, Varanasi, India
  286. 286. Center for Global Surgery, Loma Linda University, Loma Linda, CA, United States
  287. 287. Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
  288. 288. Department of Family Medicine and Public Health, University of Opole, Opole, Poland
  289. 289. Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  290. 290. Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  291. 291. Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
  292. 292. Public Health Division, Society for Education, Action and Research in Community Health, Gadchiroli, India
  293. 293. Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
  294. 294. Institute for Epidemiology and Social Medicine, University of Munster, Munster, Germany
  295. 295. Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Bukavu, Democratic Republic Congo
  296. 296. Department of Global Health, Stellenbosch University, Cape Town, South Africa
  297. 297. International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
  298. 298. Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
  299. 299. Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia
  300. 300. Medical Imaging Center, Shiraz University of Medical Sciences, Iran
  301. 301. Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
  302. 302. Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan
  303. 303. Department of Pediatrics, Rutgers University, New Brunswick, NJ, United States
  304. 304. Epidemiology Department, Jazan University, Jazan, Saudi Arabia
  305. 305. Primary Care Department, NHS North West London, London, United Kingdom
  306. 306. Department of Public Health, New Mexico State University, Las Cruces, NM, United States
  307. 307. Department of Preventive Medicine, Yonsei University, Seoul, South Korea
  308. 308. Institute of Health Services Research, Yonsei University, Seoul, South Korea
  309. 309. Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Seoul, South Korea
  310. 310. Public Health Center, Ministry of Health and Welfare, Wando-gun, South Korea
  311. 311. School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
  312. 312. School of Health Sciences, Kristiania University College, Oslo, Norway
  313. 313. Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, United States
  314. 314. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
  315. 315. Department of Public Health, University of Helsinki, Helsinki, Finland
  316. 316. Department of Environmental Health Engineering, Arak University of Medical Sciences, Arak, Iran
  317. 317. Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
  318. 318. Kasturba Medical College, Udupi, India
  319. 319. Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
  320. 320. Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
  321. 321. Department of Anthropology, Panjab University, Chandigarh, India
  322. 322. Department of Anesthesiology, Duke University, Durham, NC, United States
  323. 323. Faculty of Public Health, University of Indonesia, Depok, Indonesia
  324. 324. National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, United Kingdom
  325. 325. Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
  326. 326. Department of Neurology and Psychiatry, German Clinic of Santiago, Santiago, Chile
  327. 327. Faculty of Medicine, University of Development, Santiago, Chile
  328. 328. UO Neurologia, Salute Pubblica e Disabilita, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
  329. 329. Department of Sociology, Shenzhen University, Shenzhen, China
  330. 330. School of Public Health, Zhengzhou University, Zhengzhou, China
  331. 331. Asbestos Diseases Research Institute, Concord, NSW, Australia
  332. 332. Department of Quantitative Health Science, Case Western Reserve University, Cleveland, OH, United States
  333. 333. Department of Pediatrics, Ohio State University, Columbus, OH, United States
  334. 334. Department of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH, United States
  335. 335. Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
  336. 336. Competence Cluster for Nutrition and Cardiovascular Health (NutriCARD), Jena, Germany
  337. 337. School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
  338. 338. Department of Neurosciences and Behavioral Sciences, University of Sao Paulo, Ribeirao Preto, Brazil
  339. 339. Department of Pathology and Legal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
  340. 340. Radiology Department, Egypt Ministry of Health and Population, Mansoura, Egypt
  341. 341. Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal, India
  342. 342. Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
  343. 343. Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  344. 344. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  345. 345. School of Medicine, University of Manitoba, Winnipeg, MB, Canada
  346. 346. Value-Based Healthcare Unit, IRCCS MultiMedica, Sesto San Giovanni, Italy
  347. 347. Indonesian Public Health Association, Surabaya, Indonesia
  348. 348. Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
  349. 349. Department of Neurology, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
  350. 350. Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  351. 351. Neurology Unit, Helsinki University Hospital, Helsinki, Finland
  352. 352. School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia
  353. 353. Department of Neurology, University of Melbourne, Melbourne, VIC, Australia
  354. 354. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  355. 355. School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
  356. 356. Center for Innovation in Medical Education, Szczecin, Poland
  357. 357. Department of Propedeutics of Internal Diseases and Arterial Hypertension, Szczecin, Poland
  358. 358. Pomeranian Medical University, Szczecin, Poland
  359. 359. Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
  360. 360. Internal Medicine Programme, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  361. 361. Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  362. 362. Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
  363. 363. Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
  364. 364. Pediatric Intensive Care Unit, King Saud University, Riyadh, Saudi Arabia
  365. 365. Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
  366. 366. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  367. 367. Department of Health Care Management, Technical University of Berlin, Berlin, Germany
  368. 368. Department of Epidemiology and Biostatistics, Lorestan University of Medical Sciences, Khorramabad, Iran
  369. 369. Department of Computer Science and Engineering, Pabna University of Science and Technology, Pabna, Bangladesh
  370. 370. Department of Medicine, TMSS Medical College, Bogura, Bangladesh
  371. 371. Department of Medicine, Sofia Ismail Memorial Medical Centre, Bogura, Bangladesh
  372. 372. Department of Cardiology and Cardiac Surgery, Univeristy of Warmia and Mazury, Olsztyn, Poland
  373. 373. School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
  374. 374. Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
  375. 375. Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
  376. 376. Mysore Medical College and Research Institute, Government Medical College, Mysore, India
  377. 377. Department of Clinical Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
  378. 378. Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
  379. 379. Cardio-Aid, Bucharest, Romania
  380. 380. Bupa Clemton Park, Bupa, Sydney, NSW, Australia
  381. 381. Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
  382. 382. Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
  383. 383. Department of Clinical Sciences, Lund University, Lund, Sweden
  384. 384. Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, SA, Australia
  385. 385. School of Public Health, University of Adelaide, Adelaide, SA, Australia
  386. 386. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
  387. 387. Department of Pediatrics, National Hospital, Abuja, Nigeria
  388. 388. Department of International Public Health, University of Liverpool, Liverpool, United Kingdom
  389. 389. Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
  390. 390. Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
  391. 391. Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States
  392. 392. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  393. 393. Section of Sustainable Health, Umea University, Umea, Sweden
  394. 394. Department of Health Metrics, Center for Health Outcomes and Evaluation, Bucharest, Romania
  395. 395. Department of Health Administration and Policy, George Mason University, Fairfax, VA, United States
  396. 396. Research and Development Department, Kalinga Institute of Medical Sciences, Bhubaneswar, India
  397. 397. International Institute for Educational Planning (IIEP), Albert Einstein Hospital, Sao Paulo, Brazil
  398. 398. Department of Development Studies, International Institute for Population Sciences, Mumbai, India
  399. 399. Cancer Control Alberta, Alberta Health Services, Edmonton, AB, Canada
  400. 400. Medical College, Tairunnessa Memorial Medical College and Hospital, Gazipur, Bangladesh
  401. 401. Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
  402. 402. Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
  403. 403. University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  404. 404. School of Economics and Business, University of Groningen, Groningen, Netherlands
  405. 405. College of Medicine, University of Central Florida, Orlando, FL, United States
  406. 406. Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
  407. 407. Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  408. 408. Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  409. 409. Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
  410. 410. School of Nursing and Healthcare Professions, Federation University Australia, Berwick, VIC, Australia
  411. 411. Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
  412. 412. Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
  413. 413. University College London Hospitals, London, United Kingdom
  414. 414. Academic Public Health England, Public Health England, London, United Kingdom
  415. 415. School of Nursing and Midwifery, Royal College of Surgeons in Ireland - Bahrain, Muharraq Governorate, Bahrain
  416. 416. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  417. 417. Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
  418. 418. Department of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia
  419. 419. Department of Clinical Research, Federal University of Uberlandia, Uberlandia, Brazil
  420. 420. Department of Neuroscience, University of Perugia, Perugia, Italy
  421. 421. Department of Neurology, Infermi Hospital, Rimini, Italy
  422. 422. Department of Cardiology and Internal Medicine, University of Warmia and Mazury, Olsztyn, Poland
  423. 423. Department of Neurology, University of l'Aquila, L'Aquila, Italy
  424. 424. Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  425. 425. Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  426. 426. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  427. 427. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  428. 428. Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
  429. 429. Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
  430. 430. Department of Public Health and Health Systems, Nagoya University, Nagoya, Japan
  431. 431. Cardiovascular Intensive Care Unit, Ministry of Health and Population, Cairo, Egypt
  432. 432. Division of Infectious Diseases, University of Louisville, Louisville, KY, United States
  433. 433. Emergency Department, Brown University, Providence, RI, United States
  434. 434. Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
  435. 435. Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
  436. 436. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
  437. 437. Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
  438. 438. School of Population Health, University of New South Wales, Sydney, NSW, Australia
  439. 439. Cardiovascular Program, Sydney, NSW, Australia
  440. 440. The George Institute for Global Health, Sydney, NSW, Australia
  441. 441. National Heart, Lung, and Blood Institute, National Institute of Health, Rockville, MD, United States
  442. 442. Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
  443. 443. Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Shenzhen, China
  444. 444. Karachi, Pakistan
  445. 445. Department of Community Medicine, BLDE University, Vijayapur, India
  446. 446. The University of Tokyo, Tokyo, Japan
  447. 447. Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
  448. 448. Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil
  449. 449. School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
  450. 450. Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, United States
  451. 451. Department of Community Medicine and Public Health, Tribhuvan University, Janakpur, Nepal
  452. 452. Department No.16, Moscow Research and Practical Centre on Addictions, Moscow, Russian Federation
  453. 453. Laboratory of Genetics and Genomics, Moscow Research and Practical Centre on Addictions, Moscow, Russian Federation
  454. 454. Therapeutic Department, Balashiha Central Hospital, Balashikha, Russian Federation
  455. 455. Department of Pediatrics, King Khalid University Hospital, Riyadh, Saudi Arabia
  456. 456. Department of Cardiology, University of Bern, Bern, Switzerland
  457. 457. Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON, Canada
  458. 458. Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
  459. 459. Department of Biomedical Sciences, Arba Minch University, Arba Minch, Ethiopia
  460. 460. Research and Development Center for Humanities and Health Management, National Institute of Health Research and Development, Jakarta, Indonesia
  461. 461. Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria
  462. 462. Department of Medicine, University of Calgary, Calgary, AB, Canada
  463. 463. Modestum LTD, London, United Kingdom
  464. 464. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  465. 465. Department of Neurology, All India Institute of Medical Sciences, Delhi, India
  466. 466. Multidisciplinary Department, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
  467. 467. Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
  468. 468. Department of Microbiology, Islamic Azad University, Tehran, Iran
  469. 469. UKK Institute, Tampere, Finland
  470. 470. Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
  471. 471. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  472. 472. Faculty of Information Technology, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City, Viet Nam
  473. 473. Center for Experimental Microsurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
  474. 474. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  475. 475. Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
  476. 476. Department of Medicine, University of Rajarata, Saliyapura Anuradhapuraya, Sri Lanka
  477. 477. Institute of Health and Society, University of Oslo, Oslo, Norway
  478. 478. Department of Neurology, Technical University of Munich, Munich, Germany
  479. 479. NIHR Biomedical Research Centre, Guy's and St Thomas' Hospital, Kings College London, London, United Kingdom
  480. 480. The George Institute for Global Health, University of New South Wales, Camperdown, NSW, Australia
  481. 481. The George Institute, University of New South Wales, Kensington, NSW, Australia
  482. 482. The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia
  483. 483. Research and Development Division, The George Institute for Global Health, New Delhi, India
  484. 484. Psychology Department, University of Sheffield, Sheffield, United Kingdom
  485. 485. Department of Public Health, Fujita Health University, Toyoake, Japan
  486. 486. Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
  487. 487. Department of Public Health, Juntendo University, Tokyo, Japan
  488. 488. Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
  489. 489. School of Medicine, Wuhan University, Wuhan, China
  490. 490. Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, SC, United States
  491. 491. School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
  492. 492. Department of Neurology, University of Tennessee, Memphis, TN, United States
  493. 493. Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
  494. 494. Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
  495. 495. School of Public Health, Wuhan University of Science and Technology, Wuhan, China
  496. 496. Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
  497. 497. Health Technology Assessment Unit, Department of Health Philippines, Manila, Philippines
  498. 498. MentalHealthPH, Inc, Quezon City, Philippines
  499. 499. Department of Health Policy and Management, Kuwait University, Safat, Kuwait
  500. 500. Department of Cardiology, Centre Hospitalier Montfermeil (Montfermeil Hospital Center), Montfermeil, France
  501. 501. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  502. 502. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
  503. 503. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
  504. 504. Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  505. 505. Institute of Microengineering, Federal Polytechnic School of Lausanne, Lausanne, Switzerland
  506. 506. Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
  507. 507. Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico
  508. 508. Department of Neurology, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
  509. 509. Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran

Source: The Lancet Neurology Published:2021


Abstract

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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