1. Key messages
- In 2018, 0.7% of the population with aged 15 years and over reported having a stroke in the past year. This percentage increases with age, reaching 1.7% in people aged 65 years and over.
- In people aged 65 years and over, the self-reported prevalence of stroke was higher in men in the three regions.
- In 2021, the number of people having been diagnosed with an acute stroke was estimated at 18,550 in Belgium (161 cases per 100,000 inhabitants).
- Between 2016 and 2021, the age-adjusted incidence of acute stroke has decreased in men and women, with 11% and 15% respectively.
2. Stroke prevalence
More men than women report to have suffered from stroke
In 2018, 0.7% of the population with an aged 15 years and over reported having a stroke in the past year. This percentage increases with age, up to 1.7% in people aged 65 years and over, and to 2.4% in people aged 75 and over.
The age-adjusted self-reported prevalence of stroke was 2.0%. Stroke was more commonly reported among men across all age groups. The age-adjusted self-reported prevalence of stroke was higher in men (3.5%) than in women (0.9%).
The gender difference was more pronounced in people aged 65 and over, in whom the prevalence of stroke was 3 to 6 times as high in men.
Source: Health Interview Survey, Sciensano [1]
Stroke prevalence is higher in men than women across all regions
In 2018, among people aged 65 and over, the age-adjusted prevalence of stroke was higher in men in all regions, with the most pronounced difference in the Flemish Region. The number of women that report to have experienced a stroke in the past year is the highest in the Walloon Region, followed by the Brussels Capital Region, and the lowest in the Flemish Region. The small number of women aged 65 and over that report to have experienced a stroke in the Flemish region could be due to the small subgroup and fluctuations in the study sample.
Source: Own calculations based on Health Interview Survey, Sciensano [1]
Prevalence of stroke decreases in women aged 65 and over and increases in men aged 65 and over
In women aged 65 and over, between 1997 and 2018, the age-adjusted prevalence of stroke has dropped resulting in an overall decrease by 87% (mainly caused by an observed drop between 1997 and 2001). In men aged 65 and over, there is an increase in self-reported prevalence of 40% since 1997. However, the observed rise in prevalence among men aged 65 and over was not significant.
Among men aged 65 and over, the regional patterns have fluctuated over time and do not allow clear conclusions about the evolution. Among women aged 65 and over, the prevalence of stroke has decreased in all regions between 1997 and 2018.
- Men
- Women
Age-adjusted self-reported prevalence of stroke in men aged 65 and over, Belgium, 1997-2018
Source: Own calculations based on the Health Interview Survey, Sciensano [1]
Age-adjusted self-reported prevalence of stroke in women aged 65 and over, Belgium, 1997-2018
Source: Own calculations based on the Health Interview Survey, Sciensano [1]
Stroke prevalence is linked to education levels.
The crude self-reported prevalence of stroke in the population with an age of 65 and older is higher in people with a low level of education (3.4%) compared to people with a middle (0.9%) or high (1.4%) level of education. Even after adjustment for age, these important differences remain between different levels of education. Education level is used as an indicator for socio-economic status at the individual level. These findings suggest that the population aged 65 and over with a lower socio-economic status report a higher prevalence of stroke compared to people with higher socio-economic status.
3. Stroke incidence
Highest hospital admission rate for stroke among men in the age group 80-84, and among women in the age group 85-89
In 2021, the number of persons having been diagnosed with an acute stroke at hospital admission was estimated at 15,359 (133 diagnoses per 100,000 inhabitants), among which 13,153 were discharged alive and 2,206 died. The total number of people with an acute stroke, including those who died without being admitted to the hospital, was estimated at 18,550 in Belgium (161 cases per 100,000 inhabitants).
Among people with acute stroke, 50.6% were men. The number of people admitted to the hospital because of acute stroke was higher in men in younger age groups and higher in women in older age groups (80+ years). The highest number of acute stroke was observed in the age group 80-84 among men, and in the age group 85-89 among women. The incidence rate of stroke increases with age and was higher in men in all age groups except for the 95+ age group.
- Number of cases
- Incidence rates
Incidence of acute stroke, number of cases by age and sex, Belgium, 2021
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Incidence of acute stroke, incidence rate by age and sex, Belgium, 2021
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Lower stroke incidence in Brussels compared to other Belgian regions in 2021
In the Brussels Capital Region the age-adjusted incidence of acute stroke in 2021 was 167 per 100,000 among men and 121 per 100,000 among women, and hence lower compared to the other regions in both genders. In the Walloon Region, the age-adjusted incidence rate of acute stroke was 186 per 100,000 among men and 140 per 100,000 among women, which is comparable to the age-adjusted Belgian incidence rate (respectively 191 per 100,000 and 141 per 100,000). In the Flemish region, the age-adjusted incidence rate of acute stroke was 195 per 100,000 among men and 145 per 100,000 among women.
- Men
- Women
Incidence of acute stroke in men by region, Belgium, 2021
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Incidence of acute stroke in women by region, Belgium, 2021
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
Belgium sees decline in acute stroke incidence from 2016 to 2021
Between 2016 and 2021, the age-adjusted incidence of acute stroke has decreased in both genders in Belgium, going from 214 per 100,000 in 2016 to 190 per 100,000 in 2021 in men and from 160 per 100,000 in 2016 to 136 per 100,000 in 2021 in women. This decrease was more pronounced among women (-15%) compared to men (-11.2%).
Source: Own calculations based on FPS Health, Food Chain Safety and Environment [2] and SPMA [3]
4. Read more
View the metadata for this indicator
Background
Cerebrovascular diseases are one of the main causes of death and disability world-wide, except in lowest-income countries. Cerebrovascular diseases, of which stroke is the most common manifestation, refers to all diseases in which the blood vessels of the brain are primarily involved. Cerebrovascular diseases could lead to serious symptoms, although they can also be present without any acute symptoms. The current chapter will focus on the occurrence of stroke within Belgium, which includes ischemic and hemorrhagic stroke. An ischemic stroke occurs if an artery to the brain becomes occluded, while hemorrhagic stroke occurs if brain vessels rupture.
Epidemiological studies have identified many risk factors of stroke. The most important non-modifiable risk factors include higher age, low birth weight or genetic predisposition. Important modifiable risk factors include among others hypertension, high cholesterol levels, cardiac disease, diabetes, obesity and smoking. Hypertension is the most important modifiable risk factor for both ischemic and hemorrhagic stroke, as it is found to explain 35% of all occurrences [1].
Two indicators are presented in the following sections:
- The self-reported prevalence of stroke refers to people who have reported suffering from stroke (including cerebral hemorrhage and cerebral thrombosis) in the past 12 months, and is derived from the Belgian Health Interview Survey [1]. We shall first describe the global prevalence in people aged 15 years and more; then we will focus on people aged 65 and over.
- Different indicators can be defined to describe the occurrence of acute stroke. The "rate" (or incidence by episode) represents all first or recurrent events, while the term "incidence" means a first-ever event. Based on the availability of the data, we defined the yearly incidence as the first event in a given year. This indicator is built using the hospital discharge data from the Federal Public Service Health, Foodchain safety and Environment [2] from which infarction cases that were hospitalized and discharged alive are derived. To these cases have been added the cases of people who died of a stroke (in hospital or not), extracted from the Sciensano Standardized Procedures for Mortality Analysis (SPMA) [3].
For information concerning mortality, please consult the following pages: Overall mortality by cause and Premature mortality by cause.
Definitions
- Stroke
- Stroke, a medical emergency, occurs when blood flow to the brain is disrupted, leading to tissue damage. It manifests in two forms: ischemic, caused by a blood clot blocking an artery, and hemorrhagic, resulting from a ruptured blood vessel. Symptoms include sudden numbness, confusion, speech difficulties, and severe headache. Prompt treatment is crucial to limit brain damage. An acute stroke lasts less than 24 hours, starts suddenly, and worsens rapidly.
- Age-adjusted prevalence or incidence
- Age-adjusted prevalence or incidence is a method to compare disease rates in different populations by adjusting for age differences. It helps provide a fair comparison by estimating what the disease rates would be if all populations had the same age distribution, making comparisons more meaningful.
References
- Health Interview Survey, Sciensano, 1997-2018. https://his.wiv-isp.be/
- Federal Public Service Health, Food Chain Safety, and Environment. https://www.health.belgium.be/en/node/22892
- Standardized Procedure for Mortality Analysis (SPMA), Sciensano. https://spma.wiv-isp.be/SitePages/Methods_mortality.aspx
Please cite this page as: Sciensano. Non-Communicable Diseases: Cerebrovascular diseases, Health Status Report, 30 Aug 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/non-communicable-diseases/cerebrovascular-diseases