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Thirty-year changes in stroke demographics in the Saudi National Guard Community (1982-1992 and 2013-2024)
Awadh M Alahmari1,2,3, Alwaleed Alabdulwahed1, Abdulrahman A Almasood1
1Department of Neurology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia.
Frontiers in Neurology
|June 24, 2026
Summary
Stroke incidence decreased in Saudi Arabia, but metabolic risk factors like hypertension and diabetes significantly increased over three decades. This highlights the need for enhanced primary prevention strategies to combat rising stroke risk.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke epidemiology in Saudi Arabia has undergone significant evolution over 30 years, influenced by advancements in care, diagnostics, and demographics.
- This study compares stroke characteristics, risk factors, and outcomes in the Saudi National Guard (SANG) community across two distinct time periods.
Purpose of the Study:
- To descriptively compare stroke epidemiology, including incidence, prevalence, risk factors, and mortality, between two historical periods in Saudi Arabia.
- To identify trends in stroke characteristics and risk factors to inform public health strategies.
Main Methods:
- A retrospective comparative study analyzed 3,436 stroke patients (2013-2024) against 500 patients (1982-1992) from King Abdulaziz Medical City, Riyadh.
- Data included demographics, vascular risk factors, stroke type (TOAST), incidence, prevalence, and mortality; functional outcomes and length of stay were assessed for the modern cohort.
- An age-stratified analysis was performed on modern era data; all risk ratios are unadjusted descriptive estimates.
Main Results:
- Crude annual stroke incidence decreased (43.8 to 34.36 per 100,000), while 10-year period prevalence increased (186 to 343.6 per 100,000).
- The modern cohort was younger (mean age 59.8 vs. 63 years), and key risk factors significantly increased: hypertension (72.1% vs. 56.0%), diabetes (64.1% vs. 42.0%), and smoking (16.9% vs. 6.0%).
- All-cause mortality significantly fell (12.2% to 4.2%), while intracerebral hemorrhage incidence declined (14.6% vs. 21.4%).
Conclusions:
- Observed trends align with global patterns of decreasing stroke mortality but increasing metabolic risk burden.
- Methodological differences necessitate cautious interpretation of cross-period comparisons.
- The rising prevalence of metabolic risk factors emphasizes the critical need for targeted primary prevention initiatives in the Saudi population.
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