Trends in the Burden of Stroke in Mexico:A National and Subnational Analysis of the Global Burden of Disease 1990–2019

Background: The lack of current epidemiological information on stroke in Mexico has motivated the development of up-to-date estimations based on available data sources and published research.Methods and Results: Data of incidence, prevalence, deaths, premature mortality, disability, and DALYs due to cerebrovascular disease included in the Global Burden of Disease (GBD) 2019 study were analysed to identify differences on the burden of stroke in Mexico by type of stroke (ischaemic [IS], intracerebral haemorrhage [ICH] and subarachnoid haemorrhage [SAH]), sex, age groups, and state levels ordered by quartiles of Sociodemographic Index (SDI) from 1990 to 2019.The age-standardised mortality rate declined 41.6% during the period. Significant reductions in incidence, prevalence, DALYs, premature mortality and mortality rates of total stroke occurred mainly during the 1990 to 2005, except for premature mortality. Age-standardised mortality, premature mortality and DALYs rates for IS and ICH were significantly reduced from 1990-2005, while SAH showed no major changes during the 1990-2019 period. Differences by sex and the magnitude of decline were significant in females for total stroke for incidence, prevalence and YLDs rates. The less developed states by SDI exhibited the lowest improvements during the period, particularly for ICH metrics.Conclusions: In Mexico, the early reduction in stroke burden during 1990-2005 was not followed by a significant declining trend in the 2005-2019 period. Small differences by SDI for ICH occurred during the period 2005-2019. These findings reveal the health disparities in the burden of stroke within the fragmented Mexican Healthcare System.Funding Information: This research was supported by the Bill & Melinda Gates Foundation and INSP.Declaration of Interests: VDG, ECA, HGD, LC, and CCB declare no conflict interest in the results and interpretation of data herein presented.