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Low socioeconomic status is associated with a high stroke risk. However, few studies have quantitatively assessed the relationship between stroke burden and national economic development indicators. We explored the quantitative association between macroeconomic development and stroke burden in rural China. In this population-based, prospective study (1992-2016), we collected data on annual registrations of stroke events and deaths in Tianjin, China. Economic development over the period was represented by gross domestic product annually ad