International Stroke Burden Saw Hike Over Last 30 Years
International stroke burden has increased from 1990 to 2021, according to recent findings from a global burden of disease (GBD) study published in The Lancet Neurology.
“Our study findings continue to point out that currently used stroke prevention strategies are not sufficiently effective to halt, let alone reduce, the fast-growing stroke burden,” authors noted. “Additional, more effective stroke prevention strategies (with the emphasis on population-wide measures, task shifting from doctors to nurses or health volunteers, and the wider use of evidence-based mobile and telehealth platforms) and pragmatic solutions to address the critical gaps in stroke service delivery, along with development of context-appropriate workforce capacity building and epidemiological surveillance systems, need to be urgently implemented across all countries.”
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Authors estimated the incidence, prevalence, death, and disability-adjusted life years (DALYs) for stroke types across 204 countries from 1990 to 2021 per 100,000 people per year. They also assessed stroke burden attributable to 23 risk factors, grouped into 6 clusters, including air pollution, tobacco use, and metabolic risks. These estimates were calculated globally and regionally using standard GBD methods.
In 2021, stroke was the third leading cause of death globally, responsible for 7.3 million deaths (10.7% of all deaths), following ischemic heart disease and COVID-19. It was also the fourth leading cause of DALYs, with 160.5 million DALYs. There were notable disparities in stroke burden, with increases in incidence and mortality in regions like Southeast Asia and Oceania, particularly in countries with lower socio-demographic indices (SDI) and among people under 70. Globally, ischemic stroke made up 65.3%, intracerebral hemorrhage made up 28.8%, and subarachnoid hemorrhage made up 5.8% of incident strokes. Increases in DALYs were linked to high BMI (88.2%), high ambient temperature (72.4%), high fasting plasma glucose (32.1%), diet high in sugar-sweetened beverages (23.4%), low physical activity (11.3%), high systolic blood pressure (6.7%), lead exposure (6.5%), and diet low in omega-6 polyunsaturated fatty acids (5.3%).
“Without scaling up these innovative evidence-based strategies and policies that target local, national, regional, and global stroke prevention and care disparities, the burden of stroke will continue to grow, thus threatening the sustainability of health systems worldwide,” authors concluded.
