Abstract Body (Do not enter title and authors here): Background: Cerebrovascular diseases are one of the leading causes of death globally. Understanding the mortality trend is essential to design targeted intervention.
Objective: This study aimed to evaluate global, regional, national, sex-specific, and age-specific trends in cerebrovascular disease-associated mortality from 2000 to 2019.
Methods: The World Health Organization (WHO) mortality database comprising 119 countries was analyzed to determine the cerebrovascular-disease-associated crude mortality rates (CMR) and age-standardized mortality rates (ASMR) per 100,000 population. Trends were assessed using Average Annual Percent Change (AAPC) with 95% confidence intervals (CI).
Results: Globally, cerebrovascular disease-associated deaths decreased from 1.93 million in 2000 to 1.54 million in 2019. Global CMR decreased from 90.45 to 62.14 (AAPC: -2.40%) and ASMR from 69.86 to 37.60 (AAPC: -3.56%). All six WHO regions showed significant CMR and ASMR reduction. In 2019, Europe had the highest CMR (103.80) and the largest CMR decline (AAPC: -2.88%), while Africa had the highest ASMR (47.13). Europe also displayed the most substantial ASMR reduction (AAPC: -4.91%). In 2019, females had higher CMRs (65.55 vs. 58.38 for males; AAPC -2.70% vs. -2.00%), while males had higher ASMRs (44.73 vs. 31.89 for females; AAPC -3.43% vs. -3.74%). Country-specific analyses revealed significant heterogeneity. Countries like Thailand showed significant CMR and ASMR increases (AAPC: 6.09% and 3.40%, respectively), while Estonia displayed substantial decreases (AAPC: -6.76% and -9.07%). Age-specific CMR declines were prevalent, especially in older age groups across all regions. Europe demonstrated the most visible and consistent reductions across all ages.
Conclusion: Despite significant global and regional declines in cerebrovascular disease-associated mortality, substantial heterogeneity persists across countries, sexes, and age groups. These findings call attention to the need for targeted public health strategies to address disparities and further reduce the burden of cerebrovascular disease globally.