Abstract 188: The Burden of Stroke in Mexico: An Analysis of the Global Burden of Disease 1990-2015

Abstract

Background and purpose: Stroke incidence, prevalence and mortality have decreased in high-income countries, while in the last decades there has been an increasing trend in low- to middle-income nations, where ischemic (IS) and hemorrhagic stroke (HS) are still major causes of death and disability. The lack of updated epidemiological information of stroke in Mexico has motivated the performance of current estimations based on available direct data sources and published research. Methods: We analyzed available information cases related with cerebrovascular disease included in the Global Burden of Disease (GBD) 2015 data source. Sources available from Mexico included vital registration data and information on stroke incidence, prevalence and mortality from the scientific literature about inpatient hospital data, population surveys and mortality registries for the period 1990-2015. Results: The absolute number of stroke deaths increased substantially in the last 25 years. In 1990 there were 10,572 IS and 11,158 HS deaths, compared with 18,649 and 21,396 respectively in 2015. Conversely, age-standardized mortality rates for IS were significantly reduced by 27.8%, from 30.1 per 100,000 in 1990 to 21.8 in 2015; while the decrease for HS in the same period was 12.4%, from 26.8 to 23.5 per 100,000. However, the decrease trend in mortality for both types of stroke was observed only during the 1990-2005 period, and remained stable from 2005-2015. The age-standardized IS prevalence diminished (-27.6%) from 116.3 per 100,000 in 1990 to 84.2 in 2015, while HS decreased (-23%) from 88.6 to 68.3. Age-standardized IS incidence diminished (-34%) from 37.4 per 100,000 in 1990 to 24.6 in 2015. For HS, incidence rate decreased (-32%) from 23.2 to 15.7 per 100,000. Nevertheless, incident cases for both conditions did not show any decrease after 2005. Conclusion: Mexico exhibit an epidemiological pattern of transition, characterized by both low mortality and prevalence, which contrasts with findings for high and low- to middle-income countries. This study provides a unique insight on epidemiological trends associated with a transition towards development in a Latin American country.