Comprehensive analysis of stroke epidemiology in Vietnam: Insights from GBD 1990-2019 and RES-Q 2017-2023

Abstract

Background: Stroke is a significant health burden in Vietnam, with substantial impacts on mortality, morbidity, and healthcare resources. An up-to-date report on stroke epidemiology and associated risk factors in Vietnam was missing.

Method: We analyzed the data published in the Global Burden of Disease (GBD) 2019, in combination with the first-time analysis of the Registry of Stroke Care Quality Improvement (RES-Q) initiative in Vietnam from 2017 to 2023.

Findings: Comparative analysis globally revealed that Vietnam had one of the highest stroke incidence and prevalence rates in Southeast Asia and ranked 4th in stroke mortality among 11 neighbouring countries. In the RES-Q dataset, 95,696 patients (77 %) were ischemic stroke, 23,203 (18 %) were intracerebral haemorrhage, and 2816 (2 %) were subarachnoid haemorrhage. In GBD 2019, stroke was the leading cause of death among cardiovascular diseases in Vietnam, accounting for 135,999 fatalities. The incidence of stroke was 222 (95 % UIs 206-242) per 100,000 population, with a prevalence of 1541 (1430-1679) per 100,000. Results align with the report from the RES-Q dataset in two megacities of Vietnam: Hanoi (incidence rate of 168.9, prevalence rate of 1182.2) and Ho Chi Minh City (incidence rate of 207.1, prevalence rate of 1221.8). Key risk factors for stroke mortality are high systolic blood pressure (79,000 deaths), unhealthy dietary (43,000 deaths), high fasting plasma glucose (35,000 deaths), and air pollution (33,000 deaths). Incidence is lower in rural Vietnam, but availability and quality of care are higher in megacities.

Interpretation: The results promote a further understanding of stroke and risk factors for the Vietnamese population and suggest prevention and treatment strategies for the Vietnamese government, including facility and capacity improvement and applications of advanced technologies.

Keywords: Global burden of disease; Stroke; Stroke care management; Vietnam.

Fig. 1

Global burden of stroke in Vietnam, 2019. Panel A shows the number of deaths in 2019 from different diseases including stroke. Panel B shows the distribution of ages and sex in several deaths by stroke in Vietnam in 2019. Panel C shows the changes in risk factors for deaths from 1990 to 2019 in Vietnam. Panel D shows the percentage of stroke risk factors in Vietnam, in 2019.

Fig. 2

The mortality rate map of stroke in 2019. Panel A shows the comparison of Vietnam vs Southeast Asia Countries, according to WHO. Panel B shows the comparison of Vietnam vs Western Pacific Countries.

Fig. 3

RES-Q report of stroke in Vietnam, 2023. Panel A shows the geodemographics of Vietnam and the number of patients reported in different regions of Vietnam in 2023. Panel B shows the number of patients and stroke units involved in the RES-Q in two megacities of Vietnam (Hanoi and Ho Chi Minh City) and the rest in 2023. Panel C shows the number of stroke cases divided into stroke types in both genders in two megacities. Panel D shows the distribution of ages and sex in stroke cases reported, and panel E shows the history of medical conditions of stroke patients in Ho Chi Minh and Hanoi.