Time Trends of Epidemiology of Hemorrhagic Stroke among Urban Population in Kazakhstan


  • Yevgeniy Zhukov Kazakhstan School of Public Health, Kazakhstan Medical University, Almaty, Republic of Kazakhstan; Department of Medicine, City Clinical Hospital No7, Almaty, Republic of Kazakhstan
  • Yermek Kavtaevich Kavtaevich Dyussembekov Department of Medicine, City Clinical Hospital No7, Almaty, Republic of Kazakhstan
  • Аltyn Aringazina Kazakhstan School of Public Health, Kazakhstan Medical University, Almaty, Republic of Kazakhstan
  • Rauan Kastey Department of Medicine, City Clinical Hospital No7, Almaty, Republic of Kazakhstan
  • Kuanysh Nikatov Department of Medicine, City Clinical Hospital No7, Almaty, Republic of Kazakhstan
  • Arimantas Tamasauskas Department of Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
  • Ruslan Kulmanbetov Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
  • Anar Tursynbekova Department of Medicine, Research Institute of Cardiology and Internal Diseases, Almaty, Republic of Kazakhstan
  • Ydyrys Almabayev Department of Medicine https://orcid.org/0000-0002-5268-1675




Hemorrhagic stroke, Subarachnoid hemorrhage, Cardiovascular disease, Kazakhstan


AIM: Central Asia has been known among the highest hemorrhagic stroke (HS) and subarachnoid hemorrhage (SAH) burden regions globally. Despite the decline in cardiovascular disease mortality (CVD), HS and SAH have been remaining a public health concern in Kazakhstan. This study aimed to evaluate the trends of HS and SAH among the urban population in Kazakhstan.

METHODS: We studied HS and SAH cases aged 18 years and older between 2013 and 2017 hospitalized to stroke centers in Almaty (Kazakhstan). HS and SAH were confirmed by neuroimaging. We calculated age-standardized event, mortality and in-hospital case-fatality rates (per 100,000 populations) with 95% CIs for each individual year and over the five years using SAS University Edition and Joinpoint Regression Program.

RESULTS: Out of 2759 HS and 413 SAH cases admitted into the stroke centers of Almaty (Kazakhstan), 27.4% cases died in a hospital. The age-standardized HS event rates decreased in both sexes over the five years while age-standardized SAH event rates increased for the same period of time. The age-standardized mortality and case-fatality rates decreased in women among HS and SAH cases and men with HS. However, the age-standardized mortality and case-fatality SAH rates increased in men over same period.

CONCLUSIONS: Despite the overall decline in HS and slight increase in SAH over the 5 years, the burden remains high. We need to further monitor HS and SAH trends to develop targeted interventions and ensure that the preventive strategies are reducing the burden.



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Lazarevic S, Aleksic D, Matic T, Vesic K, Toncev S, Drakulic S, et al. Temporal variations of stroke occurence. Serb J Exp Clin Res. 2016;18:25. https://doi.org/10.1515/sjecr-2016-0025 DOI: https://doi.org/10.1515/sjecr-2016-0025

Krishnamurthi RV, Moran AE, Forouzanfar MH, Bennett DA, Mensah GA, Lawes CM, et al. The global burden of hemorrhagic stroke: A summary of findings from the GBD 2010 study. Glob Heart. 2014;9(1):101-6. https://doi.org/10.1016/j.gheart.2014.01.003 PMid:25432119 DOI: https://doi.org/10.1016/j.gheart.2014.01.003

Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 study. Neuroepidemiology. 2015;45(3):161-76. https://doi.org/10.1159/000441085 PMid:26505981 DOI: https://doi.org/10.1159/000441085

Ministry of Healthcare of the Republic of Kazakhstan. Kazakhstan Tomorrow. During the Years of Independence, Kazakhstan has Significantly Improved Health Indicators. Ministry of Healthcare of the Republic of Kazakhstan; 2020. Available from: http://dsm.gov.kz/en/pages/during-years-independence-kazakhstan-has-significantly-improved-health-indicators [Last accessed on 2021 Jul 06].

Electronic Government of the Republic of Kazakhstan. Guaranteed Volume of Free Medical Care. Who and how can get a Guaranteed volume of Free Medical Care? 2014. Available from: https://egov.kz/cms/en/articles/health_care/2Fgarant_obyiom_med_pomoshi [Last accessed on 2021 Jul 23].

Agency for Strategic Planning and Reforms of the Republic of Kazakhstan Bureau of National Statistics. Dynamics of Basic Socio-economic Indicators. Annual Demographics of the Republic of Kazakhstan 2013-2017; 2020. Available from: https://stat.gov.kz/official/industry/61/publication [Last accessed on 2021 Sep 16].

Gassanov Z, Kaidarova D, Ismailov Z, Nurgaliev N, Zhylkaidarova A, Nyushko K, et al. Study of prostate cancer prevalence in Kazakhstan. Arch Balkan Med Union. 2020;55(4):582-91. https://doi.org/10.31688/abmu.2020.55.4.04 DOI: https://doi.org/10.31688/ABMU.2020.55.4.04

Republican Center for Healthcare Development of the Ministry of Health of the Republic of Kazakhstan. Clinical Protocol of Stroke in Kazakhstan. Protocol; 2016. Available from: http://www.rcrz.kz/index.php/ru [Last accessed on 2021 Jul 25].

Ahmad OB, Pinto CB, Lopez AD. Age Standardization of Rates: A New WHO Standard. GPE Discussion Paper Series: No 31; 2001. p. 10-2.

Global, regional, and national burden of stroke, 1990-2016: A systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2019;18(5):439-58. https://doi.org/10.1016/s1474-4422(19)30034-1 PMid:30871944 DOI: https://doi.org/10.1016/S1474-4422(19)30034-1

Shah R, Wilkins E, Nichols M, Kelly P, El-Sadi F, Wright FL, et al. Epidemiology report: trends in sex-specific cerebrovascular disease mortality in Europe based on WHO mortality data. Eur Heart J. 2019;40(9):755-64. https://doi.org/10.1093/eurheartj/ehy378 PMid:30124820 DOI: https://doi.org/10.1093/eurheartj/ehy378

World Health Organization. WHO Regional Office for Europe. Better Noncommunicable Disease Outcomes: Challenges and Opportunities for Health Systems. Vol. 53. Geneva: World Health Organization; 2013. p. 1689-99.

Avan A, Digaleh H, Di Napoli M, Stranges S, Behrouz R, Shojaeianbabaei G, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: An ecological analysis from the global burden of disease study 2017. BMC Med. 2019;17:191. https://doi.org/10.1186/s12916-019-1397-3 PMid:31647003 DOI: https://doi.org/10.1186/s12916-019-1397-3

Davletov K, McKee M, Berkinbayev S, Battakova Z, Vujnovic M, Rechel B. Regional differences in cardiovascular mortality in Kazakhstan: Further evidence for the “Russian mortality paradox”? Eur J Public Health. 2015;25(5):890-4. https://doi.org/10.1093/eurpub/ckv019 PMid:25745082 DOI: https://doi.org/10.1093/eurpub/ckv019

Aringazina A, Gulis G, Allegrante JP. Public health challenges and priorities for kazakhstan. Cent Asian J Glob Health. 2012;1(1):30. https://doi.org/10.5195/cajgh.2012.30 PMid:29755863 DOI: https://doi.org/10.5195/cajgh.2012.30

Ministry of Labor and Social Protection of Population of the Republic of Kazakhstan. Kazakhstan has Launched the Decade on Prevention of Excessive Alcohol Consumption. Ministry of Labor and Social Protection of Population of the Republic of Kazakhstan; 2016. Available from: https://www.enbek.gov.kz/en/node/340746 [Last accessed on 2020 Jan 10].

O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao- Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): A case-control study. Lancet. 2010;376(9735):112-23. https://doi.org/10.1016/s0140-6736(10)60834-3 PMid:20561675 DOI: https://doi.org/10.1016/S0140-6736(10)60834-3

Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality from ischemic heart disease. Circ Cardiovasc Qual Outcomes. 2019;12(6):e005375. https://doi.org/10.1161/circoutcomes.118.005375 DOI: https://doi.org/10.1161/CIRCOUTCOMES.118.005375

Aringazina A, Kuandikov T, Arkhipov V. Burden of the cardiovascular diseases in Central Asia. Cent Asian J Glob Health. 2018;7(1):321. https://doi.org/10.5195/cajgh.2018.321 PMid:30863664 DOI: https://doi.org/10.5195/cajgh.2018.321

Kulkayeva G, Harun-Or-Rashid M, Yoshida Y, Tulebayev K, Sakamoto J. Cardiovascular disease risk factors among rural Kazakh population. Nagoya J Med Sci. 2012;74(1-2):51-61. PMid:22515111

Supiyev A, Kossumov A, Utepova L, Nurgozhin T, Zhumadilov Z, Bobak M. Prevalence, awareness, treatment and control of arterial hypertension in Astana, Kazakhstan. A cross-sectional study. Public Health. 2015;129(7):948-53. https://doi.org/10.1016/j.puhe.2015.02.020 PMid:25818013 DOI: https://doi.org/10.1016/j.puhe.2015.02.020

Katsaga A, Kulzhanov M, Karanikolos M, Rechel B. Kazakhkstan health system review. Health Syst Transit. 2012;14(4):1-154. PMid:22894852




How to Cite

Zhukov Y, Dyussembekov YKK, Aringazina А, Kastey R, Nikatov K, Tamasauskas A, Kulmanbetov R, Tursynbekova A, Almabayev Y. Time Trends of Epidemiology of Hemorrhagic Stroke among Urban Population in Kazakhstan. Open Access Maced J Med Sci [Internet]. 2022 Feb. 5 [cited 2023 Mar. 22];10(A):402-8. Available from: https://oamjms.eu/index.php/mjms/article/view/8688

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