Cardiovascular disease is the leading cause of death worldwide with almost one third of all cardiovascular deaths ascribed to stroke. In contrast to coronary heart disease, most of the strokes occur in developing countries; China alone has about 1 million deaths from stroke each year. From a global perspective the stroke situation is changing rapidly, and considerable progress has been made in documenting the changes in stroke mortality. Despite the favorable trends in stroke mortality in many countries, stroke will become an increasingly important health problem as the world's population continues to age.