The authors stated that during a 12-month period (2006–2007), they prospectively ascertained all strokes occurring in a population of 450 229. Multiple overlapping sources were used to identify people with stroke.

The results showed that a total of 624 first-ever strokes occurred during the study period, 98.4% undergoing imaging. Despite a relatively low crude annual incidence rate of first-ever stroke FES per 100 000 residents, rates adjusted to the European population aged 45 to 84 years were higher than in most other countries.

The study confirmed that age-specific stroke incidence was higher in younger patients in Mashhad/Iran than is typically seen in Western countries. Comparison of age-specific incidence rates between regions revealed that stroke in Mashhad occurs approximately 1 decade earlier than in Western countries.

This useful study concluded that the incidence of stroke in Iran is considerably greater than in most Western countries, with stroke occurring at younger ages. Ischaemic stroke incidence was also considerably greater than reported in other regions. This conclusion will have a significant implication on prevention strategies of cardiovascular diseases in general and stroke in particular in that part of the world.