Abstract WP169: Age And Sex Differences And Temporal Trend In Stroke Incidence In Latin America: A Systematic Review And Meta-analysis

Background: Studies suggest divergent temporal trends in stroke incidence in high income countries, with increasing rates in younger people, particularly women. No age- and sex-specific stroke incidence data are available for Latin American and Caribbean (LAC) regions, despite large populations undergoing rapid structural changes. Aim: To determine temporal trends in age and sex stroke incidence in LAC populations. Methods: A systematic review in accordance with MOOSE and PRISMA guidelines was undertaken with a modified Cochrane Stroke Group search strategy of MEDLINE, WOS, and LILACS databases, to identify relevant references for prospective observational studies with sex-disaggregated data on stroke incidence in LAC populations from January 1997 to December 2021. Two independent reviewers screened titles/abstracts, and reviewed selected full text articles. Random-effects meta-analysis was conducted to estimate the pooled overall crude stroke incidence and relative temporal rate ratio (RTTR) by age-groups in all and sex-disaggregated data. The Joanna Briggs Institute’s risk of bias assessment was applied. Results: Of 9242 identified records, 6 LAC studies (9 periods) were selected. Overall crude stroke incidence was higher in men than women (incidence [men:women] rate ratio [IRR] = 1.12, 95% confidence interval [CI] 1.04-1.21 [I 2 =38.3%]). When analyzed for temporal trend, relative ratio of stroke incidence was greater in younger than older age-groups (<55 vs. ≥55 years; RTTR=1.65, 95%CI 1.50-1.80), before compared to after, 2010. Overall, less favorable trends occurred in women (RTTR=1.98, 95%CI 1.75-2.21) than men (RTTR=1.42, 95%CI 1.22-1.63). Conclusions: Divergent temporal trends in stroke incidence are apparent in LAC, with less favorable trends in younger age-groups and especially in young women. Further studies are needed to understand these findings and establish strategies targeting prevention in younger populations.