A major new analysis from the Global Burden of Disease Study, published in The Lancet Neurology, reveals a significant increase in the global stroke burden from 1990 to 2021. This rise, attributed to population growth, aging populations, and increased exposure to risk factors, calls for urgent attention and improved prevention strategies.
Key Findings:
In 2021, 11.9 million new strokes were recorded, a 70% increase since 1990. Stroke survivors reached 93.8 million, and stroke-related deaths rose to 7.3 million, making stroke the third leading cause of death globally.
More than 75% of those affected live in low- and middle-income countries (LMICs).
Disability-adjusted life years (DALYs) lost to stroke increased by 32% from 1990 to 2021, reaching 160.5 million years of healthy life lost.
Despite the increase in overall cases, age-standardized rates show a decline in incidence (down 22%), prevalence (down 8%), deaths (down 39%), and DALYs (down 39%) worldwide since 1990. However, stagnation in incidence rates has been noted since 2015, particularly in Southeast Asia, East Asia, and Oceania, as well as among those under 70 years of age.
Regional Disparities: The study reveals stark differences in stroke burden across regions. High-income areas like North America and Australasia report the lowest incidence and prevalence rates. In contrast, East and Central Asia, and sub-Saharan Africa exhibit rates up to ten times higher, significantly impacting young populations.
Professor Valery L. Feigin, the lead author, emphasized the urgency of implementing effective population-wide prevention strategies, stating, “Current stroke prevention strategies are not sufficiently effective.”
Risk Factors: The burden of stroke is increasingly linked to controllable risk factors, with high body mass index (BMI), high blood pressure, and unhealthy diets contributing significantly. The study highlights that 84% of the stroke burden is attributable to modifiable risk factors, presenting an opportunity for impactful interventions.
Environmental Impact: Environmental factors, including air pollution and high ambient temperatures, are emerging as critical contributors to stroke risk. The analysis suggests that air pollution is now a leading risk factor for certain types of strokes.
Call for Action: The authors advocate for comprehensive, evidence-based strategies to address these challenges. This includes enhancing stroke service delivery, building workforce capacity, and employing mobile health technologies to improve access to care.
As Professor Feigin notes, “There are tremendous opportunities to alter the trajectory of stroke risk for the next generation.” The study underscores the need for urgent action to combat the growing stroke burden, particularly in disadvantaged regions.
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