The Epidemiology of Stroke in a Developing Country (Pakistan)

Ischaemic stroke is a major cause of neurological morbidity and mortality. The objective of this review article is to summarise facts pertaining to acute ischaemic stroke and its various aspects in a developing country like Pakistan, where resources are limited and the healthcare system is underdeveloped. No large-scale epidemiological studies are available to determine the true incidence of stroke in Pakistan. We conducted a study to determine the prevalence of several important stroke risk factors among Pakistani stroke patients, and to determine whether these risk factors differ among urban versus rural populations. We also used existing data from literature to compare overall stroke incidence in Pakistan to that in developed countries. We found that, unlike in most countries, where hypertension is the most important stroke risk factor, pregnancy/prolonged contraceptive use is the most important risk factor in our Pakistani sample. This risk factor is more prevalent in urban than in rural populations. With the exception of Germany, developed countries have lower stroke incidences than Pakistan. We highlight areas for future research.