Why Do the French Have Fewer Strokes?


Stroke incidence has been increasing worldwide over the past 50 years, while death from stroke has been decreasing in developed countries. France is a country with a lower incidence of stroke and a lower rate of stroke death than countries of equivalent socioeconomic development.


Why is Stroke Increasing While Stroke Death is Decreasing?

Stroke care has improved dramatically over the past one hundred years and has continued to improve over the past 30 years.

A stroke is a sudden event, but it takes years and years of heart disease and a long term build up of disease of the blood vessels to cause a stroke. So that means that stroke generally affects people who may have already lived long enough to survive heart disease, diabetes, cancer and hypertension. Years ago people didn't survive such illnesses, so we didn't see as much stroke.


Why Are More People Surviving Stroke?

The good news is that stroke care has improved tremendously over the past 20 years. Emergency treatment for stroke is a relatively new development in medicine and it has saved lives and improved function and recovery after stroke. Attentive medical management of stroke within the first few days has been proven improve overall survival and recovery. This means that despite increasing stroke rates, people who suffer from a stroke can go on to lead healthy lives.


What is so Unique About France?

Of course, despite the better stroke rate than seen in other countries, stroke does occur in France and people die of stroke on France.

However, the numbers show that the rate of stroke and the rate of stroke death is much lower than that of similar countries.

Overall Good Health

One of the possible explanations for the lower stroke rate in France could be the country’s overall good health. France has one of the world’s lowest rates of neonatal mortality (a high survival of babies) and high life expectancy, both of which are standards used to measure the overall health of a country.

Generally, good education and the availability and access to health care are the primary elements responsible for neonatal survival and life expectancy. France’s good healthcare availability and strong educational structure may partially contribute to the low stroke rate, but it cannot be the only explanation because other countries with similar arrangements have a higher stroke rate. 

French Culture

Some have attributed France's low stroke rate to the fact that the culture and structure of life encourages a great deal of outdoor walking - and thus large amounts of moderate exercise throughout the day. In many developed countries, exercise must be scheduled outside of work hours and only happens after other responsibilities are done, while in France, walking is part of the regular routine on the way to and from work or errands.

French Cuisine

Some have attributed the low stroke rate in France to the French diet, which incorporates a variety of foods, wine and generally modest quantities.

Low Stress

Still another possible explanation can be credited to French culture, known for an emphasis on moderation and enjoyment of life, not for the extremes of laziness and slothfulness nor for rushed, high stress.

Inherited Predispositions

Of course, genetics may play a role in France’s low stroke rate, as there is a genetic component to stroke risk demonstrated by a familial, hereditary increased predisposition to stroke.


Whether or not there could be an environmental factor to France’s low stroke rate has never been definitely determined. Certainly there are some environmental factors at play when it comes to stroke, but France isn't known for having different levels of air pollutants than neighboring countries.


Whether it is lifestyle, genetics, environment or access to health care, France has an interestingly low stroke rate. The explanation is most likely a combination of these elements, rather than a single factor.



Burden of stroke in France, Leys D, Béjot Y, Debette S, Giroud M, International Journal of stroke, May 2008 

The Incidence, Prevalence, and Mortality of Stroke in France, Germany, Italy, Spain, the UK, and the US: A Literature Review, Younan ZhangAnn-Marie ChapmanMelanie Plested,  Daniel Jackson,  and Francisco Purroy, Stroke Research and Treatment, March 2012

Cardiovascular disease in Europe 2014: epidemiological update, Nichols M, Townsend N, Scarborough P, Rayner M, European Heart Journal, November 2014

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