Why the study?
Studies in high-income countries show unfavorable trends in stroke incidence in younger populations, but temporal changes disaggregated by age and sex were uncharacterized in Latin America and the Caribbean.
Does the incidence of first-ever stroke change over time (≥2010 vs <2010) in younger versus older populations in Latin America and the Caribbean?
Does the incidence of first-ever stroke change over time (≥2010 vs <2010) in younger versus older populations in Latin America and the Caribbean?
Stroke incidence has unfavorably increased in younger populations (<55 years), particularly young women, in Latin America and the Caribbean over the last decade, contrasting with a decrease in older populations.
Unfavorable stroke incidence trends in younger LAC adults, especially women, signal prevention needs; leaves open prospective confirmation and risk-factor trials.
Background High-income countries studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region (LAC). Methods A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective observational studies with age and sex-disaggregated data of first-ever stroke (FES) incidence. Risk of bias was assessed with The Joanna Briggs Institute’s guide. The main outcomes were incidence rate ratio (IRR) and relative temporal trend ratio (RTTR) of SI, comparing time periods ≥2010 with <2010. Pooled RTTR (pRTTR) only considering studies with two periods in the same population were calculated by random-effects meta-analysis. Results From 9,242 records identified, six studies were selected including 4,483 FES in 4,101,084 individuals. Crude IRR in younger subjects (<55 years) comparing ≥2010:<2010 periods showed an increase in SI in the last decade (IRR 1.37;95%CI 1.23-1.50), in contrast to a decrease in older people during the same period (IRR 0.83; 95%CI 0.76–0.89). Overall RTTR (<55:≥55 years) was 1.65 (95CI% 1.50-1.80), with higher increase in young women (pRTTR 3.08; 95%CI 1.18-4.97; p for heterogeneity <0.001). Conclusions An unfavorable change in SI in young people - especially in women - was detected in the last decade in LAC. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision-makers. Registration of protocol CRD42022332563 (PROSPERO).
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Núñez et al. (2023) studied this question.
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