Temporal Trends in Stroke Mortality in Maranhão (2000-2021): Epidemiological Analysis and Potential Years of Life Lost

Introduction: Stroke is the second leading cause of death in Brazil and worldwide, according to the World Health Organization (WHO) and the National Center for Health Statistics (NCHS) reports. In Brazil, cerebrovascular diseases rank second in mortality statistics, with stroke being its most prevalent manifestation. In Maranhão, there is a lack of detailed analyses of the temporal trends in stroke mortality, where health indicators differ from the national scenario. Objective: To analyze the temporal trends in stroke mortality in Maranhão between 2000 and 2021, using Joinpoint regression, assessing differences by sex and age group, and calculating the potential years of life lost (PYLL). Method: Ecological time-series study, based on DATASUS secondary data of the population in Maranhão, Brazil, from 2000 to 2021, analyzed by Joinpoint regression and descriptive statistics, considering sex and age group. Results: The mortality rate (MC) due to stroke increased from 36.28 to 52.92 per 100,000 inhabitants (APV of 2.0%, p < 0.001), with two distinct periods: an increase of 9.0% per year until 2008 and a decrease of 2.1% per year until 2021. The increase was greater in men (APV of 2.3%) than in women (APV of 1.6%), with a greater impact in the 70 to 79 years age group (APV of 1.4%, p = 0.003). The PYLL totaled 363,786 years, with the greatest contribution from the 20 to 59 years age group. Conclusion: Stroke mortality in Maranhão showed a significant increase until 2008, followed by a decrease until 2021, with a greater impact on men and those aged 70 to 79 years old, and a high loss of life years in younger groups, highlighting the need for interventions targeted at these groups.