Global, regional, and national burden of stroke and its risk factors, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
Journal article
Feigin, Valery L, Abate, Melsew Dagne, Abate, Yohannes Habtegiorgis, Abd ElHafeez, Samar, Abd-Allah, Foad, Abdelalim, Ahmed, Abdelkader, Atef, Abdelmasseh, Michael, Abd-Elsalam, Sherief M., Abdi, Parsa, Abdollahi, Arash, Abdoun, Meriem, Cerin, Ester, Rahman, Aziz and et. al.. (2024). Global, regional, and national burden of stroke and its risk factors, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurology. 23(10), pp. 973-1003. https://doi.org/10.1016/S1474-4422(24)00369-7
Authors | Feigin, Valery L, Abate, Melsew Dagne, Abate, Yohannes Habtegiorgis, Abd ElHafeez, Samar, Abd-Allah, Foad, Abdelalim, Ahmed, Abdelkader, Atef, Abdelmasseh, Michael, Abd-Elsalam, Sherief M., Abdi, Parsa, Abdollahi, Arash, Abdoun, Meriem, Cerin, Ester, Rahman, Aziz and et. al. |
---|---|
Abstract | Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. |
Keywords | stroke; burden of disease; ischaemic stroke; intracerebral haemorrhage; subarachnoid haemorrhage; evidence-based health care; public health; risk factors |
Year | 01 Jan 2024 |
Journal | Lancet Neurology |
Journal citation | 23 (10), pp. 973-1003 |
Publisher | Elsevier - Lancet Publishing Group (The) |
ISSN | 1474-4422 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/S1474-4422(24)00369-7 |
Web address (URL) | https://www.sciencedirect.com/science/article/pii/S1474442224003697?via%3Dihub |
Open access | Open access |
Research or scholarly | Research |
Page range | 973-1003 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | Oct 2024 |
Publication process dates | |
Deposited | 26 Nov 2024 |
Supplemental file | License File Access Level Open |
Additional information | © 2024 The Author(s). Published by Elsevier Ltd. |
This is an Open Access article under the CC BY 4.0 | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/91159/global-regional-and-national-burden-of-stroke-and-its-risk-factors-1990-2021-a-systematic-analysis-for-the-global-burden-of-disease-study-2021
Download files
Publisher's version
OA_2024_Global_regional_and_national_burden_of.pdf | |
License: CC BY 4.0 | |
File access level: Open |
Supplemental file
SM_2024_Global_regional_and_national_burden_of.pdf | |
License: CC BY 4.0 | |
File access level: Open |
4
total views4
total downloads0
views this month0
downloads this month