Global, Regional and National Burden of Stroke among Perimenopausal Women: Trends from 1990 to 2021 and Projections up to 2044

Stroke, the second leading global cause of death, disproportionately affects perimenopausal women, though research on this population remains limited. Utilizing GBD 2021 data, this study reveals that while global stroke prevalence, incidence, and DALY cases in perimenopausal women significantly increased from 1990–2021, age-standardized rates declined overall. Middle-high and high-SDI regions demonstrated polarized trends - the UAE saw the sharpest case increases while Estonia and Latvia achieved notable reductions. Joinpoint regression analysis of these 32-year trends suggests an impending reversal: projections indicate both disease burden rates and absolute case numbers will transition from historical declines to future increases by 2044. Despite previous improvements in age-adjusted metrics, the persistent rise in cases coupled with these forecasts underscores the critical need for targeted interventions to mitigate stroke's growing impact on perimenopausal women worldwide.