Evidence map›Paper›PMID 31647003›Full record

ArticleBMC medicine2019

Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017.

Abolfazl Avan, Hadi Digaleh, Mario Di Napoli, Saverio Stranges, Reza Behrouz, Golnaz Shojaeianbabaei, Amin Amiri, Reza Tabrizi, Naghmeh Mokhber, J David Spence and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 235 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
235citing papers in PubMed, 14 pooled it
34.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

235 citing papers in PubMed, 14 syntheses or guidelines pooled it, 500 citations in OpenAlex.

  1. A systematic review of causal pathways of socioeconomic inequalities in stroke.International journal of stroke : official journal of the International Stroke Society · 2026
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  8. Efficacy of meridian massage for motor function after a stroke: a systematic review and Meta-analysis.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2022
    Pooled it
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  10. Stroke in India: A systematic review of the incidence, prevalence, and case fatality.International journal of stroke : official journal of the International Stroke Society · 2022
    Pooled it
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  12. Screening for aspiration risk associated with dysphagia in acute stroke.The Cochrane database of systematic reviews · 2021
    Pooled it
  13. The Unmet Needs of Community-Dwelling Stroke Survivors: A Systematic Review of Qualitative Studies.International journal of environmental research and public health · 2021
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  17. Augmented reality for stroke rehabilitation during COVID-19.Journal of neuroengineering and rehabilitation · 2022
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  19. Effects of N-Pep-12 dietary supplementation on neurorecovery after ischemic stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Trial
  20. Article

175 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 4 countries.

Abolfazl AvanDepartment of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Hadi DigalehNeurobiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mario Di NapoliDepartment of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy.
Saverio StrangesDepartment of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Reza BehrouzStroke Program, Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
Golnaz ShojaeianbabaeiDepartment of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Amin AmiriDepartment of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Reza TabriziHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Naghmeh MokhberDepartment of Psychiatry and Behavioural Neurosciences, Western University, London, Ontario, Canada.
J David SpenceStroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, Siebens-Drake Building, 1400 Western Rd, London, Ontario, N6G 2V4, Canada.
Mahmoud Reza AzarpazhoohDepartment of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. reza.azarpazhooh@lhsc.on.ca.
Ghaem Hospital · IRWestern University · CAEllis Hospital · USLuxembourg Institute of Health · LUMashhad University of Medical Sciences · IRShahid Beheshti University of Medical Sciences · IRShiraz University of Medical Sciences · IRThe University of Texas Health Science Center at San Antonio · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSocioeconomic status (SES) is associated with stroke incidence and mortality. Distribution of stroke risk factors is changing worldwide; evidence on these trends is crucial to the allocation of resources for prevention strategies to tackle major modifiable risk factors with the highest impact on stroke burden.

methodsWe extracted data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. We analysed trends in global and SES-specific age-standardised stroke incidence, prevalence, mortality, and disability-adjusted life years (DALYs) lost from 1990 to 2017. We also estimated the age-standardised attributable risk of stroke mortality associated with common risk factors in low-, low-middle-, upper-middle-, and high-income countries. Further, we explored the effect of age and sex on associations of risk factors with stroke mortality from 1990 to 2017.

resultsDespite a growth in crude number of stroke events from 1990 to 2017, there has been an 11.3% decrease in age-standardised stroke incidence rate worldwide (150.5, 95% uncertainty interval [UI] 140.3-161.8 per 100,000 in 2017). This has been accompanied by an overall 3.1% increase in age-standardised stroke prevalence rate (1300.6, UI 1229.0-1374.7 per 100,000 in 2017) and a 33.4% decrease in age-standardised stroke mortality rate (80.5, UI 78.9-82.6 per 100,000 in 2017) over the same time period. The rising trends in age-standardised stroke prevalence have been observed only in middle-income countries, despite declining trends in age-standardised stroke incidence and mortality in all income categories since 2005. Further, there has been almost a 34% reduction in stroke death rate (67.8, UI 64.1-71.1 per 100,000 in 2017) attributable to modifiable risk factors, more prominently in wealthier countries.

conclusionsAlmost half of stroke-related deaths are attributable to poor management of modifiable risk factors, and thus potentially preventable. We should appreciate societal barriers in lower-SES groups to design tailored preventive strategies. Despite improvements in general health knowledge, access to healthcare, and preventative strategies, SES is still strongly associated with modifiable risk factors and stroke burden; thus, screening of people from low SES at higher stroke risk is crucial.

Indexed as

Global Burden of DiseaseSocial ClassAdultAgedChild, PreschoolFemaleGlobal HealthHumansIncidenceMalePersons with DisabilitiesPrevalenceQuality-Adjusted Life YearsRisk FactorsStrokeSurvival RateCause of deathGlobal burden of diseaseGlobal healthLife styleMorbidityNon-communicable diseasesPublic health practiceRisk factorsSocioeconomic factorsStroke

Identifiers

PMID31647003
PMCPMC6813111
OpenAlexW2981488777

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.