Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review

Gisele Sampaio Silva; Jose Danilo Diestro; Christopher Tarzi; Teruko Kishibe; Antonio Bernabé-Ortiz; Rodrigo M. Carrillo-Larco; Bruce Ovbiagele; Gustavo Saposnik; Carlos Abanto; Matias Alet; Bassel Almarie; Tony Fabián Alvarez; Pablo Amaya; Sebastian Ameriso; Antonio Arauz; Miguel A. Barboza; Hernán Bayona; Juan Calleja; Vanessa Cano-Nigenda; Leonardo Augusto Carbonera; Angel Corredor; Ana Cláudia de Souza; Felipe Fregni; Rodrigo Guerrero; Claudio Jimenez; Fernando Lanas; Ramón Martinez; Sheila Martins; Paula Muñoz-Venturelli; Victor Navia; Nelson Novarro-Escudero; Verónica V. Olavarría; Octavio Pontes-Neto; Pedro Ordunez; Virginia Pujol; Alejandro A. Rabinstein; Julieta Rosales; Andres Rosende; Souvik Sen; Luciano Sposato; Fernando D. Testai; Victor Urrutia; Craig S. Anderson; Pablo M. Lavados

doi:10.1016/j.lana.2026.101466

Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review

Gisele Sampaio Silva
, Jose Danilo Diestro
, Christopher Tarzi
, Teruko Kishibe
, Antonio Bernabé-Ortiz
, Rodrigo M. Carrillo-Larco
, Bruce Ovbiagele
, Gustavo Saposnik
, Carlos Abanto
, Matias Alet
, Bassel Almarie
, Tony Fabián Alvarez
, Pablo Amaya
, Sebastian Ameriso
, Antonio Arauz
, Miguel A. Barboza
, Hernán Bayona
, Juan Calleja
, Vanessa Cano-Nigenda
, Leonardo Augusto Carbonera

Angel Corredor, Ana Cláudia de Souza, Felipe Fregni, Rodrigo Guerrero, Claudio Jimenez, Fernando Lanas, Ramón Martinez, Sheila Martins, Paula Muñoz-Venturelli, Victor Navia, Nelson Novarro-Escudero, Verónica V. Olavarría, Octavio Pontes-Neto, Pedro Ordunez, Virginia Pujol, Alejandro A. Rabinstein, Julieta Rosales, Andres Rosende, Souvik Sen, Luciano Sposato, Fernando D. Testai, Victor Urrutia, Craig S. Anderson, Pablo M. Lavados

School of Medicine

Research output: Contribution to journal › Review article › peer-review

Abstract

Stroke remains a leading cause of death and disability across the Americas, disproportionately affecting low- and middle-income countries. According to the 2023 Global Burden of Disease (GBD) Study, the Americas recorded approximately 1.2 million incident strokes and 15.7 million prevalent cases. This narrative review synthesizes epidemiological evidence on stroke trends in the Americas, with emphasis on disparities in healthcare access. We integrated estimates from the GBD, peer-reviewed studies and national surveillance systems. Although age-standardized stroke rates declined after 1990, recent analyses demonstrate a concerning resurgence, particularly among younger adults. Stroke incidence, prevalence, and disability burden vary widely across countries. Latin America and the Caribbean show higher incidence but lower prevalence than high-income settings, reflecting limited access to acute care and higher case fatality. Socioeconomic and racial inequities drive delayed treatment and poorer functional outcomes. Over 75% of stroke burden is attributable to modifiable risk factors. Urgent system-level action is needed.

Original language	English (US)
Article number	101466
Journal	The Lancet Regional Health - Americas
Volume	58
DOIs	https://doi.org/10.1016/j.lana.2026.101466
State	Published - Jun 2026

Keywords

Americas
Burden
Disparities
Ethnicity
Race
Risk factors
Sex
Stroke

ASJC Scopus subject areas

Internal Medicine
Health Policy
Public Health, Environmental and Occupational Health

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10.1016/j.lana.2026.101466

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Silva, G. S., Diestro, J. D., Tarzi, C., Kishibe, T., Bernabé-Ortiz, A., Carrillo-Larco, R. M., Ovbiagele, B., Saposnik, G., Abanto, C., Alet, M., Almarie, B., Alvarez, T. F., Amaya, P., Ameriso, S., Arauz, A., Barboza, M. A., Bayona, H., Calleja, J., Cano-Nigenda, V., ... Lavados, P. M. (2026). Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review. The Lancet Regional Health - Americas, 58, Article 101466. https://doi.org/10.1016/j.lana.2026.101466

Silva, GS, Diestro, JD, Tarzi, C, Kishibe, T, Bernabé-Ortiz, A, Carrillo-Larco, RM, Ovbiagele, B, Saposnik, G, Abanto, C, Alet, M, Almarie, B, Alvarez, TF, Amaya, P, Ameriso, S, Arauz, A, Barboza, MA, Bayona, H, Calleja, J, Cano-Nigenda, V, Carbonera, LA, Corredor, A, de Souza, AC, Fregni, F, Guerrero, R, Jimenez, C, Lanas, F, Martinez, R, Martins, S, Muñoz-Venturelli, P, Navia, V, Novarro-Escudero, N, Olavarría, VV, Pontes-Neto, O, Ordunez, P, Pujol, V, Rabinstein, AA, Rosales, J, Rosende, A, Sen, S, Sposato, L, Testai, FD, Urrutia, V, Anderson, CS & Lavados, PM 2026, 'Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review', The Lancet Regional Health - Americas, vol. 58, 101466. https://doi.org/10.1016/j.lana.2026.101466

@article{f162ad976595462e80788c79ae03169b,

title = "Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review",

abstract = "Stroke remains a leading cause of death and disability across the Americas, disproportionately affecting low- and middle-income countries. According to the 2023 Global Burden of Disease (GBD) Study, the Americas recorded approximately 1.2 million incident strokes and 15.7 million prevalent cases. This narrative review synthesizes epidemiological evidence on stroke trends in the Americas, with emphasis on disparities in healthcare access. We integrated estimates from the GBD, peer-reviewed studies and national surveillance systems. Although age-standardized stroke rates declined after 1990, recent analyses demonstrate a concerning resurgence, particularly among younger adults. Stroke incidence, prevalence, and disability burden vary widely across countries. Latin America and the Caribbean show higher incidence but lower prevalence than high-income settings, reflecting limited access to acute care and higher case fatality. Socioeconomic and racial inequities drive delayed treatment and poorer functional outcomes. Over 75\% of stroke burden is attributable to modifiable risk factors. Urgent system-level action is needed.",

keywords = "Americas, Burden, Disparities, Ethnicity, Race, Risk factors, Sex, Stroke",

author = "Silva, \{Gisele Sampaio\} and Diestro, \{Jose Danilo\} and Christopher Tarzi and Teruko Kishibe and Antonio Bernab{\'e}-Ortiz and Carrillo-Larco, \{Rodrigo M.\} and Bruce Ovbiagele and Gustavo Saposnik and Carlos Abanto and Matias Alet and Bassel Almarie and Alvarez, \{Tony Fabi{\'a}n\} and Pablo Amaya and Sebastian Ameriso and Antonio Arauz and Barboza, \{Miguel A.\} and Hern{\'a}n Bayona and Juan Calleja and Vanessa Cano-Nigenda and Carbonera, \{Leonardo Augusto\} and Angel Corredor and \{de Souza\}, \{Ana Cl{\'a}udia\} and Felipe Fregni and Rodrigo Guerrero and Claudio Jimenez and Fernando Lanas and Ram{\'o}n Martinez and Sheila Martins and Paula Mu{\~n}oz-Venturelli and Victor Navia and Nelson Novarro-Escudero and Olavarr{\'i}a, \{Ver{\'o}nica V.\} and Octavio Pontes-Neto and Pedro Ordunez and Virginia Pujol and Rabinstein, \{Alejandro A.\} and Julieta Rosales and Andres Rosende and Souvik Sen and Luciano Sposato and Testai, \{Fernando D.\} and Victor Urrutia and Anderson, \{Craig S.\} and Lavados, \{Pablo M.\}",

note = "Publisher Copyright: {\textcopyright} 2026 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND IGO license. http://creativecommons.org/licenses/by-nc-nd/3.0/igo",

year = "2026",

month = jun,

doi = "10.1016/j.lana.2026.101466",

language = "English (US)",

volume = "58",

journal = "The Lancet Regional Health - Americas",

issn = "2667-193X",

publisher = "Elsevier Ltd",

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TY - JOUR

T1 - Epidemiology and risk factors of stroke in the Americas

T2 - a comprehensive narrative literature review

AU - Silva, Gisele Sampaio

AU - Diestro, Jose Danilo

AU - Tarzi, Christopher

AU - Kishibe, Teruko

AU - Bernabé-Ortiz, Antonio

AU - Carrillo-Larco, Rodrigo M.

AU - Ovbiagele, Bruce

AU - Saposnik, Gustavo

AU - Abanto, Carlos

AU - Alet, Matias

AU - Almarie, Bassel

AU - Alvarez, Tony Fabián

AU - Amaya, Pablo

AU - Ameriso, Sebastian

AU - Arauz, Antonio

AU - Barboza, Miguel A.

AU - Bayona, Hernán

AU - Calleja, Juan

AU - Cano-Nigenda, Vanessa

AU - Carbonera, Leonardo Augusto

AU - Corredor, Angel

AU - de Souza, Ana Cláudia

AU - Fregni, Felipe

AU - Guerrero, Rodrigo

AU - Jimenez, Claudio

AU - Lanas, Fernando

AU - Martinez, Ramón

AU - Martins, Sheila

AU - Muñoz-Venturelli, Paula

AU - Navia, Victor

AU - Novarro-Escudero, Nelson

AU - Olavarría, Verónica V.

AU - Pontes-Neto, Octavio

AU - Ordunez, Pedro

AU - Pujol, Virginia

AU - Rabinstein, Alejandro A.

AU - Rosales, Julieta

AU - Rosende, Andres

AU - Sen, Souvik

AU - Sposato, Luciano

AU - Testai, Fernando D.

AU - Urrutia, Victor

AU - Anderson, Craig S.

AU - Lavados, Pablo M.

PY - 2026/6

Y1 - 2026/6

N2 - Stroke remains a leading cause of death and disability across the Americas, disproportionately affecting low- and middle-income countries. According to the 2023 Global Burden of Disease (GBD) Study, the Americas recorded approximately 1.2 million incident strokes and 15.7 million prevalent cases. This narrative review synthesizes epidemiological evidence on stroke trends in the Americas, with emphasis on disparities in healthcare access. We integrated estimates from the GBD, peer-reviewed studies and national surveillance systems. Although age-standardized stroke rates declined after 1990, recent analyses demonstrate a concerning resurgence, particularly among younger adults. Stroke incidence, prevalence, and disability burden vary widely across countries. Latin America and the Caribbean show higher incidence but lower prevalence than high-income settings, reflecting limited access to acute care and higher case fatality. Socioeconomic and racial inequities drive delayed treatment and poorer functional outcomes. Over 75% of stroke burden is attributable to modifiable risk factors. Urgent system-level action is needed.

AB - Stroke remains a leading cause of death and disability across the Americas, disproportionately affecting low- and middle-income countries. According to the 2023 Global Burden of Disease (GBD) Study, the Americas recorded approximately 1.2 million incident strokes and 15.7 million prevalent cases. This narrative review synthesizes epidemiological evidence on stroke trends in the Americas, with emphasis on disparities in healthcare access. We integrated estimates from the GBD, peer-reviewed studies and national surveillance systems. Although age-standardized stroke rates declined after 1990, recent analyses demonstrate a concerning resurgence, particularly among younger adults. Stroke incidence, prevalence, and disability burden vary widely across countries. Latin America and the Caribbean show higher incidence but lower prevalence than high-income settings, reflecting limited access to acute care and higher case fatality. Socioeconomic and racial inequities drive delayed treatment and poorer functional outcomes. Over 75% of stroke burden is attributable to modifiable risk factors. Urgent system-level action is needed.

KW - Americas

KW - Burden

KW - Disparities

KW - Ethnicity

KW - Race

KW - Risk factors

KW - Sex

KW - Stroke

UR - https://www.scopus.com/pages/publications/105041233771

UR - https://www.scopus.com/pages/publications/105041233771#tab=citedBy

U2 - 10.1016/j.lana.2026.101466

DO - 10.1016/j.lana.2026.101466

M3 - Review article

C2 - 42326555

AN - SCOPUS:105041233771

SN - 2667-193X

VL - 58

JO - The Lancet Regional Health - Americas

JF - The Lancet Regional Health - Americas

M1 - 101466

ER -

Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review

Abstract

Keywords

ASJC Scopus subject areas

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