Trends and Determinants of Stroke Burden in Türkiye, 2000-2023: An Analysis Using Global Burden of Disease Data.

INTRODUCTION: Stroke is a major cause of death and disability worldwide, including Türkiye. This study examined the trends and socioeconomic determinants of these deaths. METHODS: This is an ecological observational study performed in Türkiye which evaluate burden of stroke incidence, deaths and disability-adjusted life year (DALY) rates between 2000 and 2023 using the GBD 2023 dataset. Moreover, the study evaluated the effects of macroeconomic socioeconomic indicators including Universal Health Coverage (UHC), Total Health Expenditure (THE) and Gross National Income per capita (GNI) on stroke outcomes. RESULTS: Between 2000 and 2023, the age-standardized stroke incidence rate declined from 141.47 to 103.05 per 100,000 population, while the age-standardized death rate decreased from 132.61 to 57.03 and the age-standardized DALY rate declined from 2696.30 to 1073.51 per 100,000 population. In 2023, the largest proportion of stroke-related deaths was attributed to metabolic risk factors (38.24%), with high blood pressure (21.29%) being the main risk factor among metabolic risk factors, smoking (12.20%) among behavioral risks, and exposure to ambient particulate matter (11.93%) among environmental risks. Regression analyses showed that UHC service capacity was positively associated with death rates but not with stroke incidence or DALY. THE was positively correlated with incidence, negatively correlated with death, and had no significant effect on DALYs. GNI was negatively correlated with incidence, death, and DALY rates. CONCLUSION: Age-standardized stroke incidence, death, and DALY rates declined substantially in Türkiye between 2000 and 2023. However, persistent metabolic risk factors and socioeconomic inequalities underscore the need for comprehensive prevention strategies that integrate primary prevention with improvements in healthcare access and broader socioeconomic development.