Registry-recorded stroke and transient ischaemic attack diagnoses in Saudi Arabia, 2016–2025: a national descriptive analysis

Background Stroke is a major cause of death and disability globally, and its prevalence is growing as modifiable risk factors become more prevalent and the population ages. In Saudi Arabia, evidence is mainly from hospital or local data, and national descriptions of cerebrovascular diagnoses recorded in routinely collected health data remain limited in Saudi Arabia. Objective This study aimed to describe the cumulative registry-recorded burden of adults with a qualifying stroke-related or transient ischemic attack (TIA) diagnosis in the Population Health Observatory (PHO) in Saudi Arabia, using linked national health data from 2016 to 2025. This includes the registry-recorded burden, demographics and characteristics, comorbidities and healthcare utilization. Methods We conducted a national retrospective descriptive analysis of de-identified aggregate outputs from linked PHO data for 2016–2025, a descriptive statistical analysis of 68,634 stroke-diagnosed individuals in the Kingdom of Saudi Arabia. The observational study was conducted using PHO data from 2016 to 2025. Results The PHO identified 68,634 unique adults with a qualifying cerebrovascular diagnosis. Stroke burden was disproportionately concentrated in males (64.45%) and in both genders aged 60–69 years (23.27%). The accumulated count corresponded to 0.26% of the 2025 adult population; this is a crude descriptive ratio, not prevalence. Najran had the highest crude regional ratio at 0.38%. BMI was missing/invalid for 39,481 (57.52%). Among 29,153 with valid BMI, 10,494 (36.00%) were overweight and 9,930 (34.06%) were obese. The PHO low-multimorbidity category contained 42,882 individuals (62.48%); it is an administrative stratum, not a validated cardiovascular-risk score; most visits were to outpatient departments. Conclusion Saudi Arabia's recorded stroke burden is concentrated among older males. The findings describe patterns captured by the PHO and should not be interpreted as prevalence, incidence, or causal associations, which indicate the need for better prevention, management of chronic diseases and a robust national surveillance system to inform policies based on evidence to support Saudi Vision 2030.