Sex Differences in Stroke Incidence, Prevalence, Mortality and DALYs: Results from the Global Burden of Disease Study 2013
Identifieur interne : 002C77 ( Ncbi/Merge ); précédent : 002C76; suivant : 002C78Sex Differences in Stroke Incidence, Prevalence, Mortality and DALYs: Results from the Global Burden of Disease Study 2013
Auteurs : Suzanne L. Barker-Collo ; Derrick A. Bennett ; Rita Krishnamurthi ; Priya Parmar ; Valery L. Feigin ; Mohsen Naghavi ; Mohammad H. Forouzanfar ; Catherine Johnson ; Grant Nguyen ; George A. Mensah ; Theo Vos ; Christopher Murray ; Gregory A. Roth ; Foad Abd-Allah ; Semaw Ferede Abera ; Rufus O. Akinyemi ; Cecilia Bahit ; Amitava Banerjee ; Sanjay Basu ; Michael Brainin ; Natan M. Bornstein ; Valeria Caso ; Ferrán Catalá-L Pez ; Rajiv Chowdhury ; Hanne Christensen ; Merceded Colomar ; Stephen Davis ; Gabrielle Deveber ; Samath D. Dharmaratne ; Geoffrey Donnan ; Prabhakaran Dorairaj ; Klara Dokova ; Matthias Endres ; Jefferson G. Fernandes ; J. Marianne Geleijnse ; Richard F. Gillum ; Maurice Giroud ; Jiang Guohong ; Randah R. Hamadeh ; Graeme J. Hankey ; Panniyammakal Jeemon ; Kim Yun Jin ; Jost B. Jonas ; Yogesh Kalkonde ; Andre P. Kengne ; Daniel Kim ; Brett M. Kissela ; Yoshihiro Kokubo ; Pablo Lavados ; Patrice Lindsay ; Paulo A. Lotufo ; Mark T. Mackay ; Reza Malekzadeh ; Man Mohan Mehndiratta ; Devina Nand ; Bo Norrving ; Jeyaraj Durai Pandian ; Harry Perkins ; Farshad Pourmalek ; Stefano Ricci ; Patricia M. Riccio ; David Rojas-Rueda ; Nobhojit Roy ; Ralph L. Sacco ; Ramesh Sahathevan ; Kevin N. Sheth ; Ivy Shiue ; Luciano A. Sposato ; David Tanne ; Amanda Thrift ; George Thurston ; David Tirschwell ; Narayanaswamy Venketasubramanian ; Vasiliy Vlassov ; Ronny Westerman ; Charles WolfeSource :
- Neuroepidemiology [ 0251-5350 ] ; 2015.
Abstract
Accurate information on stroke burden in men and women are important for evidence-based health care planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time.
Stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and healthy years lost due to disability (YLDs) were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence, and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UI) were computed.
In 2013 global ischaemic stroke (IS) and haemorrhagic stroke (HS) incidence (per 100 000) in men (IS 132.77 [95% UI, 125.34-142.77]; HS 64.89 [95% UI 59.82-68.85]) exceeded those of women (IS 98.85 [95%UI, 92.11 - 106.62]; HS 45.48 [95% UI, 42.43-48.53]). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 [95% UI, 137.87-157-66]; 1990 female IS incidence 113.31 [95%UI, 103.52 – 123.40]), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 = 65.31 [95% UI, 61.63 – 69.0], 2013 = 64.89[95% UI, 59.82-68.85]), but was significant for females (1990= 64.892 [95% UI, 59.82-68.85], 2013= 45.48 [95% UI, 42.427-48.53]). The number of DALYs related to IS rose from 1990 (male = 16.62 [95% UI, 13.27-19.62] female = 17.53 [95% UI, 14.08-20.33]) to 2013 (male = 25.22 [95% UI, 20.57-29.13], female = 22.21 [95% UI, 17.71 – 25.50]). The number of DALYs associated with HS also rose steadily and was higher than DALYs for IS at each time point (male1990 = 29.91[95% UI, 25.66-34.54], male 2013 = 37.27 [95% UI, 32.29-45.12]; female1990= 26.05 [95% UI, 21.70- 30.90], female2013= 28.18 [95% UI, 23.68-33.80]).
Globally, men continue to have a higher incidence of IS then women while significant sex differences in the incidence of HS were not observed. The total health loss due to stroke as measured by DALYs was similar for men and women for both stroke subtypes in 2013, with HS higher than IS. Both IS and HS DALYs show an increasing trend for both men and women since 1990 which is statistically significant only for IS among men. Ongoing monitoring of sex differences in the burden of stroke will be needed to determine if disease rates among men and women continue to diverge. Sex disparities related to stroke will have important clinical and policy implications that can guide funding and resource allocation for national, regional and global health programs.
Url:
DOI: 10.1159/000441103
PubMed: 26505984
PubMed Central: 4632242
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Barker-Collo</name></author><author><name sortKey="Bennett, Derrick A" sort="Bennett, Derrick A" uniqKey="Bennett D" first="Derrick A." last="Bennett">Derrick A. Bennett</name></author><author><name sortKey="Krishnamurthi, Rita" sort="Krishnamurthi, Rita" uniqKey="Krishnamurthi R" first="Rita" last="Krishnamurthi">Rita Krishnamurthi</name></author><author><name sortKey="Parmar, Priya" sort="Parmar, Priya" uniqKey="Parmar P" first="Priya" last="Parmar">Priya Parmar</name></author><author><name sortKey="Feigin, Valery L" sort="Feigin, Valery L" uniqKey="Feigin V" first="Valery L" last="Feigin">Valery L. Feigin</name></author><author><name sortKey="Naghavi, Mohsen" sort="Naghavi, Mohsen" uniqKey="Naghavi M" first="Mohsen" last="Naghavi">Mohsen Naghavi</name></author><author><name sortKey="Forouzanfar, Mohammad H" sort="Forouzanfar, Mohammad H" uniqKey="Forouzanfar M" first="Mohammad H." last="Forouzanfar">Mohammad H. Forouzanfar</name></author><author><name sortKey="Johnson, Catherine" sort="Johnson, Catherine" uniqKey="Johnson C" first="Catherine" last="Johnson">Catherine Johnson</name></author><author><name sortKey="Nguyen, Grant" sort="Nguyen, Grant" uniqKey="Nguyen G" first="Grant" last="Nguyen">Grant Nguyen</name></author><author><name sortKey="Mensah, George A" sort="Mensah, George A" uniqKey="Mensah G" first="George A." last="Mensah">George A. Mensah</name></author><author><name sortKey="Vos, Theo" sort="Vos, Theo" uniqKey="Vos T" first="Theo" last="Vos">Theo Vos</name></author><author><name sortKey="Murray, Christopher" sort="Murray, Christopher" uniqKey="Murray C" first="Christopher" last="Murray">Christopher Murray</name></author><author><name sortKey="Roth, Gregory A" sort="Roth, Gregory A" uniqKey="Roth G" first="Gregory A." last="Roth">Gregory A. Roth</name></author><author><name sortKey="Abd Allah, Foad" sort="Abd Allah, Foad" uniqKey="Abd Allah F" first="Foad" last="Abd-Allah">Foad Abd-Allah</name></author><author><name sortKey="Abera, Semaw Ferede" sort="Abera, Semaw Ferede" uniqKey="Abera S" first="Semaw Ferede" last="Abera">Semaw Ferede Abera</name></author><author><name sortKey="Akinyemi, Rufus O" sort="Akinyemi, Rufus O" uniqKey="Akinyemi R" first="Rufus O." last="Akinyemi">Rufus O. Akinyemi</name></author><author><name sortKey="Bahit, Cecilia" sort="Bahit, Cecilia" uniqKey="Bahit C" first="Cecilia" last="Bahit">Cecilia Bahit</name></author><author><name sortKey="Banerjee, Amitava" sort="Banerjee, Amitava" uniqKey="Banerjee A" first="Amitava" last="Banerjee">Amitava Banerjee</name></author><author><name sortKey="Basu, Sanjay" sort="Basu, Sanjay" uniqKey="Basu S" first="Sanjay" last="Basu">Sanjay Basu</name></author><author><name sortKey="Brainin, Michael" sort="Brainin, Michael" uniqKey="Brainin M" first="Michael" last="Brainin">Michael Brainin</name></author><author><name sortKey="Bornstein, Natan M" sort="Bornstein, Natan M" uniqKey="Bornstein N" first="Natan M." last="Bornstein">Natan M. Bornstein</name></author><author><name sortKey="Caso, Valeria" sort="Caso, Valeria" uniqKey="Caso V" first="Valeria" last="Caso">Valeria Caso</name></author><author><name sortKey="Catala L Pez, Ferran" sort="Catala L Pez, Ferran" uniqKey="Catala L Pez F" first="Ferrán" last="Catalá-L Pez">Ferrán Catalá-L Pez</name></author><author><name sortKey="Chowdhury, Rajiv" sort="Chowdhury, Rajiv" uniqKey="Chowdhury R" first="Rajiv" last="Chowdhury">Rajiv Chowdhury</name></author><author><name sortKey="Christensen, Hanne" sort="Christensen, Hanne" uniqKey="Christensen H" first="Hanne" last="Christensen">Hanne Christensen</name></author><author><name sortKey="Colomar, Merceded" sort="Colomar, Merceded" uniqKey="Colomar M" first="Merceded" last="Colomar">Merceded Colomar</name></author><author><name sortKey="Davis, Stephen" sort="Davis, Stephen" uniqKey="Davis S" first="Stephen" last="Davis">Stephen Davis</name></author><author><name sortKey="Deveber, Gabrielle" sort="Deveber, Gabrielle" uniqKey="Deveber G" first="Gabrielle" last="Deveber">Gabrielle Deveber</name></author><author><name sortKey="Dharmaratne, Samath D" sort="Dharmaratne, Samath D" uniqKey="Dharmaratne S" first="Samath D." last="Dharmaratne">Samath D. Dharmaratne</name></author><author><name sortKey="Donnan, Geoffrey" sort="Donnan, Geoffrey" uniqKey="Donnan G" first="Geoffrey" last="Donnan">Geoffrey Donnan</name></author><author><name sortKey="Dorairaj, Prabhakaran" sort="Dorairaj, Prabhakaran" uniqKey="Dorairaj P" first="Prabhakaran" last="Dorairaj">Prabhakaran Dorairaj</name></author><author><name sortKey="Dokova, Klara" sort="Dokova, Klara" uniqKey="Dokova K" first="Klara" last="Dokova">Klara Dokova</name></author><author><name sortKey="Endres, Matthias" sort="Endres, Matthias" uniqKey="Endres M" first="Matthias" last="Endres">Matthias Endres</name></author><author><name sortKey="Fernandes, Jefferson G" sort="Fernandes, Jefferson G" uniqKey="Fernandes J" first="Jefferson G" last="Fernandes">Jefferson G. Fernandes</name></author><author><name sortKey="Geleijnse, J Marianne" sort="Geleijnse, J Marianne" uniqKey="Geleijnse J" first="J. Marianne" last="Geleijnse">J. Marianne Geleijnse</name></author><author><name sortKey="Gillum, Richard F" sort="Gillum, Richard F" uniqKey="Gillum R" first="Richard F." last="Gillum">Richard F. Gillum</name></author><author><name sortKey="Giroud, Maurice" sort="Giroud, Maurice" uniqKey="Giroud M" first="Maurice" last="Giroud">Maurice Giroud</name></author><author><name sortKey="Guohong, Jiang" sort="Guohong, Jiang" uniqKey="Guohong J" first="Jiang" last="Guohong">Jiang Guohong</name></author><author><name sortKey="Hamadeh, Randah R" sort="Hamadeh, Randah R" uniqKey="Hamadeh R" first="Randah R." last="Hamadeh">Randah R. Hamadeh</name></author><author><name sortKey="Hankey, Graeme J" sort="Hankey, Graeme J" uniqKey="Hankey G" first="Graeme J." last="Hankey">Graeme J. Hankey</name></author><author><name sortKey="Jeemon, Panniyammakal" sort="Jeemon, Panniyammakal" uniqKey="Jeemon P" first="Panniyammakal" last="Jeemon">Panniyammakal Jeemon</name></author><author><name sortKey="Jin, Kim Yun" sort="Jin, Kim Yun" uniqKey="Jin K" first="Kim Yun" last="Jin">Kim Yun Jin</name></author><author><name sortKey="Jonas, Jost B" sort="Jonas, Jost B" uniqKey="Jonas J" first="Jost B." last="Jonas">Jost B. Jonas</name></author><author><name sortKey="Kalkonde, Yogesh" sort="Kalkonde, Yogesh" uniqKey="Kalkonde Y" first="Yogesh" last="Kalkonde">Yogesh Kalkonde</name></author><author><name sortKey="Kengne, Andre P" sort="Kengne, Andre P" uniqKey="Kengne A" first="Andre P" last="Kengne">Andre P. Kengne</name></author><author><name sortKey="Kim, Daniel" sort="Kim, Daniel" uniqKey="Kim D" first="Daniel" last="Kim">Daniel Kim</name></author><author><name sortKey="Kissela, Brett M" sort="Kissela, Brett M" uniqKey="Kissela B" first="Brett M." last="Kissela">Brett M. Kissela</name></author><author><name sortKey="Kokubo, Yoshihiro" sort="Kokubo, Yoshihiro" uniqKey="Kokubo Y" first="Yoshihiro" last="Kokubo">Yoshihiro Kokubo</name></author><author><name sortKey="Lavados, Pablo" sort="Lavados, Pablo" uniqKey="Lavados P" first="Pablo" last="Lavados">Pablo Lavados</name></author><author><name sortKey="Lindsay, Patrice" sort="Lindsay, Patrice" uniqKey="Lindsay P" first="Patrice" last="Lindsay">Patrice Lindsay</name></author><author><name sortKey="Lotufo, Paulo A" sort="Lotufo, Paulo A" uniqKey="Lotufo P" first="Paulo A" last="Lotufo">Paulo A. Lotufo</name></author><author><name sortKey="Mackay, Mark T" sort="Mackay, Mark T" uniqKey="Mackay M" first="Mark T." last="Mackay">Mark T. Mackay</name></author><author><name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name></author><author><name sortKey="Mehndiratta, Man Mohan" sort="Mehndiratta, Man Mohan" uniqKey="Mehndiratta M" first="Man Mohan" last="Mehndiratta">Man Mohan Mehndiratta</name></author><author><name sortKey="Nand, Devina" sort="Nand, Devina" uniqKey="Nand D" first="Devina" last="Nand">Devina Nand</name></author><author><name sortKey="Norrving, Bo" sort="Norrving, Bo" uniqKey="Norrving B" first="Bo" last="Norrving">Bo Norrving</name></author><author><name sortKey="Pandian, Jeyaraj Durai" sort="Pandian, Jeyaraj Durai" uniqKey="Pandian J" first="Jeyaraj Durai" last="Pandian">Jeyaraj Durai Pandian</name></author><author><name sortKey="Perkins, Harry" sort="Perkins, Harry" uniqKey="Perkins H" first="Harry" last="Perkins">Harry Perkins</name></author><author><name sortKey="Pourmalek, Farshad" sort="Pourmalek, Farshad" uniqKey="Pourmalek F" first="Farshad" last="Pourmalek">Farshad Pourmalek</name></author><author><name sortKey="Ricci, Stefano" sort="Ricci, Stefano" uniqKey="Ricci S" first="Stefano" last="Ricci">Stefano Ricci</name></author><author><name sortKey="Riccio, Patricia M" sort="Riccio, Patricia M" uniqKey="Riccio P" first="Patricia M." last="Riccio">Patricia M. Riccio</name></author><author><name sortKey="Rojas Rueda, David" sort="Rojas Rueda, David" uniqKey="Rojas Rueda D" first="David" last="Rojas-Rueda">David Rojas-Rueda</name></author><author><name sortKey="Roy, Nobhojit" sort="Roy, Nobhojit" uniqKey="Roy N" first="Nobhojit" last="Roy">Nobhojit Roy</name></author><author><name sortKey="Sacco, Ralph L" sort="Sacco, Ralph L" uniqKey="Sacco R" first="Ralph L." last="Sacco">Ralph L. Sacco</name></author><author><name sortKey="Sahathevan, Ramesh" sort="Sahathevan, Ramesh" uniqKey="Sahathevan R" first="Ramesh" last="Sahathevan">Ramesh Sahathevan</name></author><author><name sortKey="Sheth, Kevin N" sort="Sheth, Kevin N" uniqKey="Sheth K" first="Kevin N." last="Sheth">Kevin N. Sheth</name></author><author><name sortKey="Shiue, Ivy" sort="Shiue, Ivy" uniqKey="Shiue I" first="Ivy" last="Shiue">Ivy Shiue</name></author><author><name sortKey="Sposato, Luciano A" sort="Sposato, Luciano A" uniqKey="Sposato L" first="Luciano A." last="Sposato">Luciano A. Sposato</name></author><author><name sortKey="Tanne, David" sort="Tanne, David" uniqKey="Tanne D" first="David" last="Tanne">David Tanne</name></author><author><name sortKey="Thrift, Amanda" sort="Thrift, Amanda" uniqKey="Thrift A" first="Amanda" last="Thrift">Amanda Thrift</name></author><author><name sortKey="Thurston, George" sort="Thurston, George" uniqKey="Thurston G" first="George" last="Thurston">George Thurston</name></author><author><name sortKey="Tirschwell, David" sort="Tirschwell, David" uniqKey="Tirschwell D" first="David" last="Tirschwell">David Tirschwell</name></author><author><name sortKey="Venketasubramanian, Narayanaswamy" sort="Venketasubramanian, Narayanaswamy" uniqKey="Venketasubramanian N" first="Narayanaswamy" last="Venketasubramanian">Narayanaswamy Venketasubramanian</name></author><author><name sortKey="Vlassov, Vasiliy" sort="Vlassov, Vasiliy" uniqKey="Vlassov V" first="Vasiliy" last="Vlassov">Vasiliy Vlassov</name></author><author><name sortKey="Westerman, Ronny" sort="Westerman, Ronny" uniqKey="Westerman R" first="Ronny" last="Westerman">Ronny Westerman</name></author><author><name sortKey="Wolfe, Charles" sort="Wolfe, Charles" uniqKey="Wolfe C" first="Charles" last="Wolfe">Charles Wolfe</name></author></analytic><series><title level="j">Neuroepidemiology</title><idno type="ISSN">0251-5350</idno><idno type="eISSN">1423-0208</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P2">Accurate information on stroke burden in men and women are important for evidence-based health care planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time.</p></sec><sec id="S2"><title>Methods</title><p id="P3">Stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and healthy years lost due to disability (YLDs) were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence, and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UI) were computed.</p></sec><sec id="S3"><title>Findings</title><p id="P4">In 2013 global ischaemic stroke (IS) and haemorrhagic stroke (HS) incidence (per 100 000) in men (IS 132.77 [95% UI, 125.34-142.77]; HS 64.89 [95% UI 59.82-68.85]) exceeded those of women (IS 98.85 [95%UI, 92.11 - 106.62]; HS 45.48 [95% UI, 42.43-48.53]). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 [95% UI, 137.87-157-66]; 1990 female IS incidence 113.31 [95%UI, 103.52 – 123.40]), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 <sub>=</sub> 65.31 [95% UI, 61.63 – 69.0], 2013 = 64.89[95% UI, 59.82-68.85]), but was significant for females (1990= 64.892 [95% UI, 59.82-68.85], 2013= 45.48 [95% UI, 42.427-48.53]). The number of DALYs related to IS rose from 1990 (male = 16.62 [95% UI, 13.27-19.62] female = 17.53 [95% UI, 14.08-20.33]) to 2013 (male = 25.22 [95% UI, 20.57-29.13], female = 22.21 [95% UI, 17.71 – 25.50]). The number of DALYs associated with HS also rose steadily and was higher than DALYs for IS at each time point (male<sub>1990</sub> = 29.91[95% UI, 25.66-34.54], male <sub>2013</sub> = 37.27 [95% UI, 32.29-45.12]; female<sub>1990</sub>= 26.05 [95% UI, 21.70- 30.90], female<sub>2013</sub>= 28.18 [95% UI, 23.68-33.80]).</p></sec><sec id="S4"><title>Interpretation</title><p id="P5">Globally, men continue to have a higher incidence of IS then women while significant sex differences in the incidence of HS were not observed. The total health loss due to stroke as measured by DALYs was similar for men and women for both stroke subtypes in 2013, with HS higher than IS. Both IS and HS DALYs show an increasing trend for both men and women since 1990 which is statistically significant only for IS among men. Ongoing monitoring of sex differences in the burden of stroke will be needed to determine if disease rates among men and women continue to diverge. Sex disparities related to stroke will have important clinical and policy implications that can guide funding and resource allocation for national, regional and global health programs.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8218700</journal-id><journal-id journal-id-type="pubmed-jr-id">6054</journal-id><journal-id journal-id-type="nlm-ta">Neuroepidemiology</journal-id><journal-id journal-id-type="iso-abbrev">Neuroepidemiology</journal-id><journal-title-group><journal-title>Neuroepidemiology</journal-title></journal-title-group><issn pub-type="ppub">0251-5350</issn><issn pub-type="epub">1423-0208</issn></journal-meta><article-meta><article-id pub-id-type="pmid">26505984</article-id><article-id pub-id-type="pmc">4632242</article-id><article-id pub-id-type="doi">10.1159/000441103</article-id><article-id pub-id-type="manuscript">NIHMS726302</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Sex Differences in Stroke Incidence, Prevalence, Mortality and DALYs: Results from the Global Burden of Disease Study 2013</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Barker-Collo</surname><given-names>Suzanne L.</given-names></name><degrees>PhD</degrees><aff id="A1">School of Psychology, level 6, 10 Symonds Street, The University of Auckland, Private Bag 92019, Auckland, New Zealand.</aff></contrib><contrib contrib-type="author"><name><surname>Bennett</surname><given-names>Derrick A.</given-names></name><aff id="A2">Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK</aff></contrib><contrib contrib-type="author"><name><surname>Krishnamurthi</surname><given-names>Rita</given-names></name><degrees>PhD</degrees><aff id="A3">National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand</aff></contrib><contrib contrib-type="author"><name><surname>Parmar</surname><given-names>Priya</given-names></name><aff id="A4">National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand</aff></contrib><contrib contrib-type="author"><name><surname>Feigin</surname><given-names>Valery L</given-names></name><degrees>MD, MSc, PhD, FAAN</degrees><role>Professor of Epidemiology and Neurology</role><aff id="A5">National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand</aff></contrib><contrib contrib-type="author"><name><surname>Naghavi</surname><given-names>Mohsen</given-names></name><aff id="A6">Department of Global Health, School of Medicine and Public Health, University of Washington</aff></contrib><contrib contrib-type="author"><name><surname>Forouzanfar</surname><given-names>Mohammad H.</given-names></name><aff id="A7">Institute for Health metrics and Evaluatrion. University of Washington, Seattle, Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Johnson</surname><given-names>Catherine</given-names></name><aff id="A8">Institute for Health Metrics and Evaluation. University of Washington, Seattle, Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Nguyen</surname><given-names>Grant</given-names></name><aff id="A9">Institute for Health Metrics and Evaluation. University of Washington, Seattle, Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Mensah</surname><given-names>George A.</given-names></name><aff id="A10">Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Vos</surname><given-names>Theo</given-names></name><aff id="A11">Department of Global Health, School of Medicine and Public Health, University of Washington, Seattle, Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Murray</surname><given-names>Christopher</given-names></name><aff id="A12">Department of Global Health, School of Medicine and Public Health, University of Washington, Seattle, Washington, USA</aff></contrib><contrib contrib-type="author"><name><surname>Roth</surname><given-names>Gregory A.</given-names></name><aff id="A13">Institute for Health Metrics and Evaluation and the Division of Cardiology, School of Medicine, University of Washington, Seattle, Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Abd-Allah</surname><given-names>Foad</given-names></name><aff id="A14">Department of Neurology, Cairo University, Cairo, Egypt.</aff></contrib><contrib contrib-type="author"><name><surname>Abera</surname><given-names>Semaw Ferede</given-names></name><aff id="A15">Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Mekelle University, Ethiopia</aff></contrib><contrib contrib-type="author"><name><surname>Akinyemi</surname><given-names>Rufus, O.</given-names></name><aff id="A16">Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria</aff></contrib><contrib contrib-type="author"><name><surname>Bahit</surname><given-names>Cecilia</given-names></name><aff id="A17">Department of Cardiology INECO Neurociencias Oroño, Rosario, Santa Fe. New Mexico, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Banerjee</surname><given-names>Amitava</given-names></name><aff id="A18">Farr Institute of Health Informatics Research, University College London, London, UK.</aff></contrib><contrib contrib-type="author"><name><surname>Basu</surname><given-names>Sanjay</given-names></name><aff id="A19">School of Medicine, Stanford Universityl, Stanford, California, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Brainin</surname><given-names>Michael</given-names></name><aff id="A20">Department of Clinical Neurology, Danube University Krems and Karl Landsteiner University, Krems, Austria</aff></contrib><contrib contrib-type="author"><name><surname>Bornstein</surname><given-names>Natan M.</given-names></name><aff id="A21">Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.</aff></contrib><contrib contrib-type="author"><name><surname>Caso</surname><given-names>Valeria</given-names></name><aff id="A22">Stroke Unit, University of Perugia, Perugia, Italy</aff></contrib><contrib contrib-type="author"><name><surname>Catalá-López</surname><given-names>Ferrán</given-names></name><aff id="A23">Department of Medicine, University of Valencia, Valencia, Spain</aff></contrib><contrib contrib-type="author"><name><surname>Chowdhury</surname><given-names>Rajiv</given-names></name><aff id="A24">Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.</aff></contrib><contrib contrib-type="author"><name><surname>Christensen</surname><given-names>Hanne</given-names></name><aff id="A25">University of Copenhagen and Bispebjerg Hospital, Denmark</aff></contrib><contrib contrib-type="author"><name><surname>Colomar</surname><given-names>Merceded</given-names></name><aff id="A26">Unidad de Investigacion Clinica y Epidemiologica Montevideo, Uruguay</aff></contrib><contrib contrib-type="author"><name><surname>Davis</surname><given-names>Stephen</given-names></name><role>Professor of Translational Neuroscience</role><aff id="A27">University of Melbourne Parkville, Australia.</aff></contrib><contrib contrib-type="author"><name><surname>deVeber</surname><given-names>Gabrielle</given-names></name><degrees>MD</degrees><aff id="A28">Children's Stroke Program, Division of Neurology Hospital for Sick Children Senior Scientist, Research Institute, Hospital for Sick Children, Torontro, Ontario, Canada.</aff></contrib><contrib contrib-type="author"><name><surname>Dharmaratne</surname><given-names>Samath D.</given-names></name><aff id="A29">Department of Community Medicine, Faculty of Medicine, University of Peradeniya and Institute for Health Metrics and Evaluation, Department of Global Health, School of Public Health, University of Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Donnan</surname><given-names>Geoffrey</given-names></name><aff id="A30">The Florey Institute of Neuroscience and Mental Health and School of Neurology. University of Melbourne, Melbourne, Australia.</aff></contrib><contrib contrib-type="author"><name><surname>Dorairaj</surname><given-names>Prabhakaran</given-names></name><aff id="A31">Centre for Chronic Conditions and Injuries and Public Health Foundation of India, Delhi, India.</aff></contrib><contrib contrib-type="author"><name><surname>Dokova</surname><given-names>Klara</given-names></name><aff id="A32">Department of Social Medicine and Health Care Organization Faculty of Public Health, Medical University of Varna, Varna, Bulgaria</aff></contrib><contrib contrib-type="author"><name><surname>Endres</surname><given-names>Matthias</given-names></name><aff id="A33">Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Germany.</aff></contrib><contrib contrib-type="author"><name><surname>Fernandes</surname><given-names>Jefferson G</given-names></name><aff id="A34">School of Health Education and Sciences German Hospital Oswaldo Cruz São Paulo, Brazil.</aff></contrib><contrib contrib-type="author"><name><surname>Geleijnse</surname><given-names>J. Marianne</given-names></name><aff id="A35">Division of Human Nutrition / Epidemiology, Wageningen University, The Netherlands.</aff></contrib><contrib contrib-type="author"><name><surname>Gillum</surname><given-names>Richard F.</given-names></name><aff id="A36">Department of Internal Medicine and Department of Community and Family Medicine, Howard University College of Medicine, Washington, DC. USA</aff></contrib><contrib contrib-type="author"><name><surname>Giroud</surname><given-names>Maurice</given-names></name><aff id="A37">Dijon Stroke Registry, Service de Neurologie, Dijon, France.</aff></contrib><contrib contrib-type="author"><name><surname>Guohong</surname><given-names>Jiang</given-names></name><aff id="A38">Tianjin Centers for Diseases Control and Prevention, School of Public Health, Tianjin Medical University, and School of Public Health, Tongji Medical University, Hubei, China.</aff></contrib><contrib contrib-type="author"><name><surname>Hamadeh</surname><given-names>Randah R.</given-names></name><aff id="A39">Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.</aff></contrib><contrib contrib-type="author"><name><surname>Hankey</surname><given-names>Graeme J.</given-names></name><aff id="A40">School of Medicine and Pharmacology, The University of Western Australia.</aff></contrib><contrib contrib-type="author"><name><surname>Jeemon</surname><given-names>Panniyammakal</given-names></name><aff id="A41">Centre for Control of Chronic Conditions, Public Health Foundation of India and Centre for Chronic Disease Control, New Delhi.</aff></contrib><contrib contrib-type="author"><name><surname>Jin</surname><given-names>Kim Yun</given-names></name><aff id="A42">Faculty of Chinese Medicine Southern University College, Johor. Malaysia</aff></contrib><contrib contrib-type="author"><name><surname>Jonas</surname><given-names>Jost B.</given-names></name><aff id="A43">Department of Ophthalmology, Medical Faculty Mannheim of the University of Heidelberg, Mannheim Germany.</aff></contrib><contrib contrib-type="author"><name><surname>Kalkonde</surname><given-names>Yogesh</given-names></name><aff id="A44">Society for Education, Action & Research in Community Health, District of Gadchiroli, India.</aff></contrib><contrib contrib-type="author"><name><surname>Kengne</surname><given-names>Andre P</given-names></name><aff id="A45">South African Medical Research Council, Francie van Zijl Drive, Parrow Valley, Cape Town, South Africa.</aff></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Daniel</given-names></name><aff id="A46">Department of Health Sciences, Northeastern University, Boston, USA</aff></contrib><contrib contrib-type="author"><name><surname>Kissela</surname><given-names>Brett M.</given-names></name><aff id="A47">Department of Neurology and Rehabilitation Medicine, University of Cincinnati, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Kokubo</surname><given-names>Yoshihiro</given-names></name><aff id="A48">Departoment of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.</aff></contrib><contrib contrib-type="author"><name><surname>Lavados</surname><given-names>Pablo</given-names></name><aff id="A49">Servicio de Neurología, Departamento de Medicina, Clínica Alemana de Santiago-Universidad del Desarrollo. Santiago, Chile.</aff></contrib><contrib contrib-type="author"><name><surname>Lindsay</surname><given-names>Patrice</given-names></name><aff id="A50">Stroke Heart and Stroke Foundation, Fondation des maladies du cœur et de l'AVC, Ontario, Canada.</aff></contrib><contrib contrib-type="author"><name><surname>Lotufo</surname><given-names>Paulo A</given-names></name><aff id="A51">Centre for Clinical and Epidemiological Research, University of Sao Paulo, Sao Paulo, Brazil.</aff></contrib><contrib contrib-type="author"><name><surname>Mackay</surname><given-names>Mark T.</given-names></name><aff id="A52">Department of Neurology, Royal Children's Hospital Melbourne and Murdoch Childrens Research Institute, Parkville Australia.</aff></contrib><contrib contrib-type="author"><name><surname>Malekzadeh</surname><given-names>Reza</given-names></name><aff id="A53">Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.</aff></contrib><contrib contrib-type="author"><name><surname>Mehndiratta</surname><given-names>Man Mohan</given-names></name><aff id="A54">Janakpuri Super Speciality Hospital, New Delhi, India</aff></contrib><contrib contrib-type="author"><name><surname>Nand</surname><given-names>Devina</given-names></name><aff id="A55">Health Information Unit, Dinem Hous, Toorak, Suva, Republic of Fiji</aff></contrib><contrib contrib-type="author"><name><surname>Norrving</surname><given-names>Bo</given-names></name><aff id="A56">Department of Clinical Sciences, Neurology, Lund University, Sweden.</aff></contrib><contrib contrib-type="author"><name><surname>Pandian</surname><given-names>Jeyaraj Durai</given-names></name><aff id="A57">Department of Neurology Christian Medical College, Ludhiana, Punjab, India.</aff></contrib><contrib contrib-type="author"><name><surname>Perkins</surname><given-names>Harry</given-names></name><aff id="A58">Institute of Medical Research, QEII Medical Centre, Perth, Western Australia</aff></contrib><contrib contrib-type="author"><name><surname>Pourmalek</surname><given-names>Farshad</given-names></name><aff id="A59">School of Population and Public Health, University of British Columbia</aff></contrib><contrib contrib-type="author"><name><surname>Ricci</surname><given-names>Stefano</given-names></name><aff id="A60">UO Nurologia, Umbria edi di Città di Castello e Branca.</aff></contrib><contrib contrib-type="author"><name><surname>Riccio</surname><given-names>Patricia M.</given-names></name><aff id="A61">Department of Clinical Neurological Sciences. Londonde Health Sciences Centre. Western University. London, ON. Canada.</aff></contrib><contrib contrib-type="author"><name><surname>Rojas-Rueda</surname><given-names>David</given-names></name><aff id="A62">Centre for Research in Environmental Epidemiology, ISGlobal, Barcelona, Spain.</aff></contrib><contrib contrib-type="author"><name><surname>Roy</surname><given-names>Nobhojit</given-names></name><aff id="A63">Environmental health resource hub, School of Habitat studies, Tata Institute of Social sciences, Mumbai, India</aff></contrib><contrib contrib-type="author"><name><surname>Sacco</surname><given-names>Ralph, L.</given-names></name><aff id="A64">University of Miami Miller School of Medicine, Department of Neurology, Miami, Florida, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Sahathevan</surname><given-names>Ramesh</given-names></name><aff id="A65">Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun RazakKuala Lumpur, Malaysia; and Calvary Healthcare Bruce, ACT, Australia</aff></contrib><contrib contrib-type="author"><name><surname>Sheth</surname><given-names>Kevin N.</given-names></name><aff id="A66">Division of Neurocritical Care and Emergency Department of Neurology Neurosciences Intensive Care Unit, Yale School of Medicine & Yale New Haven Hospital, New York, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Shiue</surname><given-names>Ivy</given-names></name><aff id="A67">Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.</aff></contrib><contrib contrib-type="author"><name><surname>Sposato</surname><given-names>Luciano A.</given-names></name><aff id="A68">Department of Clinical Neurological Sciences. London Health Sciences Centre. Western University. London, Ontario. Canada.</aff></contrib><contrib contrib-type="author"><name><surname>Tanne</surname><given-names>David</given-names></name><aff id="A69">Chaim Sheba Medical Center and Tel-Aviv University, Israel.</aff></contrib><contrib contrib-type="author"><name><surname>Thrift</surname><given-names>Amanda</given-names></name><aff id="A70">Stroke and Ageing Research (STARC), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia</aff></contrib><contrib contrib-type="author"><name><surname>Thurston</surname><given-names>George</given-names></name><aff id="A71">Department of Population Health and Environmental Medicine, Tuxedo, New York, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Tirschwell</surname><given-names>David</given-names></name><aff id="A72">University of Washington School of Medicine, UW Medicine Comprehensive Stroke Center, Harborview Medical Center, Seattle Washington, USA.</aff></contrib><contrib contrib-type="author"><name><surname>Venketasubramanian</surname><given-names>Narayanaswamy</given-names></name><aff id="A73">Raffles Neuroscience Centre, Raffles Hospital, Singapore.</aff></contrib><contrib contrib-type="author"><name><surname>Vlassov</surname><given-names>Vasiliy</given-names></name><aff id="A74">National Research University Higher School of Economics, Moscow, Russia.</aff></contrib><contrib contrib-type="author"><name><surname>Westerman</surname><given-names>Ronny</given-names></name><aff id="A75">Competence Center Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany</aff></contrib><contrib contrib-type="author"><name><surname>Wolfe</surname><given-names>Charles</given-names></name><aff id="A76">Division of Health and Social Care Research, King's College London, London, United Kingdom; and National Institute for Health Research Comprehensive Biomedical Research Centre, Guy's & St. Thomas’ NHS Foundation Trust and King's College London, London, UK</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author"><collab>on behalf of the GBD 2013 Stroke Panel Experts Group</collab><xref ref-type="author-notes" rid="FN1">*</xref></contrib></contrib-group><author-notes><fn id="FN1"><label>*</label><p id="P1">GBD Stroke Expert Writing Group members listed at the end of the paper</p></fn><corresp id="CR1"><bold>Corresponding author</bold>: Suzanne Barker-Collo, PhD, School of Psychology, level 6, 10 Symonds Street, The University of Auckland, Private Bag 92019, Auckland, New Zealand. <email>s.barker-collo@auckland.ac.nz</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>29</day><month>10</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>28</day><month>10</month><year>2015</year></pub-date><pub-date pub-type="ppub"><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>28</day><month>10</month><year>2016</year></pub-date><volume>45</volume><issue>3</issue><fpage>203</fpage><lpage>214</lpage><pmc-comment>elocation-id from pubmed: 10.1159/000441103</pmc-comment>
<abstract><sec id="S1"><title>Background</title><p id="P2">Accurate information on stroke burden in men and women are important for evidence-based health care planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time.</p></sec><sec id="S2"><title>Methods</title><p id="P3">Stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and healthy years lost due to disability (YLDs) were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence, and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UI) were computed.</p></sec><sec id="S3"><title>Findings</title><p id="P4">In 2013 global ischaemic stroke (IS) and haemorrhagic stroke (HS) incidence (per 100 000) in men (IS 132.77 [95% UI, 125.34-142.77]; HS 64.89 [95% UI 59.82-68.85]) exceeded those of women (IS 98.85 [95%UI, 92.11 - 106.62]; HS 45.48 [95% UI, 42.43-48.53]). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 [95% UI, 137.87-157-66]; 1990 female IS incidence 113.31 [95%UI, 103.52 – 123.40]), but the only significant change in IS incidence was among women. Changes in global HS incidence were not statistically significant for males (1990 <sub>=</sub> 65.31 [95% UI, 61.63 – 69.0], 2013 = 64.89[95% UI, 59.82-68.85]), but was significant for females (1990= 64.892 [95% UI, 59.82-68.85], 2013= 45.48 [95% UI, 42.427-48.53]). The number of DALYs related to IS rose from 1990 (male = 16.62 [95% UI, 13.27-19.62] female = 17.53 [95% UI, 14.08-20.33]) to 2013 (male = 25.22 [95% UI, 20.57-29.13], female = 22.21 [95% UI, 17.71 – 25.50]). The number of DALYs associated with HS also rose steadily and was higher than DALYs for IS at each time point (male<sub>1990</sub> = 29.91[95% UI, 25.66-34.54], male <sub>2013</sub> = 37.27 [95% UI, 32.29-45.12]; female<sub>1990</sub>= 26.05 [95% UI, 21.70- 30.90], female<sub>2013</sub>= 28.18 [95% UI, 23.68-33.80]).</p></sec><sec id="S4"><title>Interpretation</title><p id="P5">Globally, men continue to have a higher incidence of IS then women while significant sex differences in the incidence of HS were not observed. The total health loss due to stroke as measured by DALYs was similar for men and women for both stroke subtypes in 2013, with HS higher than IS. Both IS and HS DALYs show an increasing trend for both men and women since 1990 which is statistically significant only for IS among men. Ongoing monitoring of sex differences in the burden of stroke will be needed to determine if disease rates among men and women continue to diverge. Sex disparities related to stroke will have important clinical and policy implications that can guide funding and resource allocation for national, regional and global health programs.</p></sec></abstract><kwd-group><kwd>sex differences</kwd><kwd>stroke</kwd><kwd>epidemiology</kwd><kwd>burden</kwd><kwd>global</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Abd Allah, Foad" sort="Abd Allah, Foad" uniqKey="Abd Allah F" first="Foad" last="Abd-Allah">Foad Abd-Allah</name><name sortKey="Abera, Semaw Ferede" sort="Abera, Semaw Ferede" uniqKey="Abera S" first="Semaw Ferede" last="Abera">Semaw Ferede Abera</name><name sortKey="Akinyemi, Rufus O" sort="Akinyemi, Rufus O" uniqKey="Akinyemi R" first="Rufus O." last="Akinyemi">Rufus O. Akinyemi</name><name sortKey="Bahit, Cecilia" sort="Bahit, Cecilia" uniqKey="Bahit C" first="Cecilia" last="Bahit">Cecilia Bahit</name><name sortKey="Banerjee, Amitava" sort="Banerjee, Amitava" uniqKey="Banerjee A" first="Amitava" last="Banerjee">Amitava Banerjee</name><name sortKey="Barker Collo, Suzanne L" sort="Barker Collo, Suzanne L" uniqKey="Barker Collo S" first="Suzanne L." last="Barker-Collo">Suzanne L. Barker-Collo</name><name sortKey="Basu, Sanjay" sort="Basu, Sanjay" uniqKey="Basu S" first="Sanjay" last="Basu">Sanjay Basu</name><name sortKey="Bennett, Derrick A" sort="Bennett, Derrick A" uniqKey="Bennett D" first="Derrick A." last="Bennett">Derrick A. Bennett</name><name sortKey="Bornstein, Natan M" sort="Bornstein, Natan M" uniqKey="Bornstein N" first="Natan M." last="Bornstein">Natan M. Bornstein</name><name sortKey="Brainin, Michael" sort="Brainin, Michael" uniqKey="Brainin M" first="Michael" last="Brainin">Michael Brainin</name><name sortKey="Caso, Valeria" sort="Caso, Valeria" uniqKey="Caso V" first="Valeria" last="Caso">Valeria Caso</name><name sortKey="Catala L Pez, Ferran" sort="Catala L Pez, Ferran" uniqKey="Catala L Pez F" first="Ferrán" last="Catalá-L Pez">Ferrán Catalá-L Pez</name><name sortKey="Chowdhury, Rajiv" sort="Chowdhury, Rajiv" uniqKey="Chowdhury R" first="Rajiv" last="Chowdhury">Rajiv Chowdhury</name><name sortKey="Christensen, Hanne" sort="Christensen, Hanne" uniqKey="Christensen H" first="Hanne" last="Christensen">Hanne Christensen</name><name sortKey="Colomar, Merceded" sort="Colomar, Merceded" uniqKey="Colomar M" first="Merceded" last="Colomar">Merceded Colomar</name><name sortKey="Davis, Stephen" sort="Davis, Stephen" uniqKey="Davis S" first="Stephen" last="Davis">Stephen Davis</name><name sortKey="Deveber, Gabrielle" sort="Deveber, Gabrielle" uniqKey="Deveber G" first="Gabrielle" last="Deveber">Gabrielle Deveber</name><name sortKey="Dharmaratne, Samath D" sort="Dharmaratne, Samath D" uniqKey="Dharmaratne S" first="Samath D." last="Dharmaratne">Samath D. Dharmaratne</name><name sortKey="Dokova, Klara" sort="Dokova, Klara" uniqKey="Dokova K" first="Klara" last="Dokova">Klara Dokova</name><name sortKey="Donnan, Geoffrey" sort="Donnan, Geoffrey" uniqKey="Donnan G" first="Geoffrey" last="Donnan">Geoffrey Donnan</name><name sortKey="Dorairaj, Prabhakaran" sort="Dorairaj, Prabhakaran" uniqKey="Dorairaj P" first="Prabhakaran" last="Dorairaj">Prabhakaran Dorairaj</name><name sortKey="Endres, Matthias" sort="Endres, Matthias" uniqKey="Endres M" first="Matthias" last="Endres">Matthias Endres</name><name sortKey="Feigin, Valery L" sort="Feigin, Valery L" uniqKey="Feigin V" first="Valery L" last="Feigin">Valery L. Feigin</name><name sortKey="Fernandes, Jefferson G" sort="Fernandes, Jefferson G" uniqKey="Fernandes J" first="Jefferson G" last="Fernandes">Jefferson G. Fernandes</name><name sortKey="Forouzanfar, Mohammad H" sort="Forouzanfar, Mohammad H" uniqKey="Forouzanfar M" first="Mohammad H." last="Forouzanfar">Mohammad H. Forouzanfar</name><name sortKey="Geleijnse, J Marianne" sort="Geleijnse, J Marianne" uniqKey="Geleijnse J" first="J. Marianne" last="Geleijnse">J. Marianne Geleijnse</name><name sortKey="Gillum, Richard F" sort="Gillum, Richard F" uniqKey="Gillum R" first="Richard F." last="Gillum">Richard F. Gillum</name><name sortKey="Giroud, Maurice" sort="Giroud, Maurice" uniqKey="Giroud M" first="Maurice" last="Giroud">Maurice Giroud</name><name sortKey="Guohong, Jiang" sort="Guohong, Jiang" uniqKey="Guohong J" first="Jiang" last="Guohong">Jiang Guohong</name><name sortKey="Hamadeh, Randah R" sort="Hamadeh, Randah R" uniqKey="Hamadeh R" first="Randah R." last="Hamadeh">Randah R. Hamadeh</name><name sortKey="Hankey, Graeme J" sort="Hankey, Graeme J" uniqKey="Hankey G" first="Graeme J." last="Hankey">Graeme J. 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Lotufo</name><name sortKey="Mackay, Mark T" sort="Mackay, Mark T" uniqKey="Mackay M" first="Mark T." last="Mackay">Mark T. Mackay</name><name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name><name sortKey="Mehndiratta, Man Mohan" sort="Mehndiratta, Man Mohan" uniqKey="Mehndiratta M" first="Man Mohan" last="Mehndiratta">Man Mohan Mehndiratta</name><name sortKey="Mensah, George A" sort="Mensah, George A" uniqKey="Mensah G" first="George A." last="Mensah">George A. 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Sheth</name><name sortKey="Shiue, Ivy" sort="Shiue, Ivy" uniqKey="Shiue I" first="Ivy" last="Shiue">Ivy Shiue</name><name sortKey="Sposato, Luciano A" sort="Sposato, Luciano A" uniqKey="Sposato L" first="Luciano A." last="Sposato">Luciano A. Sposato</name><name sortKey="Tanne, David" sort="Tanne, David" uniqKey="Tanne D" first="David" last="Tanne">David Tanne</name><name sortKey="Thrift, Amanda" sort="Thrift, Amanda" uniqKey="Thrift A" first="Amanda" last="Thrift">Amanda Thrift</name><name sortKey="Thurston, George" sort="Thurston, George" uniqKey="Thurston G" first="George" last="Thurston">George Thurston</name><name sortKey="Tirschwell, David" sort="Tirschwell, David" uniqKey="Tirschwell D" first="David" last="Tirschwell">David Tirschwell</name><name sortKey="Venketasubramanian, Narayanaswamy" sort="Venketasubramanian, Narayanaswamy" uniqKey="Venketasubramanian N" first="Narayanaswamy" last="Venketasubramanian">Narayanaswamy Venketasubramanian</name><name sortKey="Vlassov, Vasiliy" sort="Vlassov, Vasiliy" uniqKey="Vlassov V" first="Vasiliy" last="Vlassov">Vasiliy Vlassov</name><name sortKey="Vos, Theo" sort="Vos, Theo" uniqKey="Vos T" first="Theo" last="Vos">Theo Vos</name><name sortKey="Westerman, Ronny" sort="Westerman, Ronny" uniqKey="Westerman R" first="Ronny" last="Westerman">Ronny Westerman</name><name sortKey="Wolfe, Charles" sort="Wolfe, Charles" uniqKey="Wolfe C" first="Charles" last="Wolfe">Charles Wolfe</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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