Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.
Details
Serval ID
serval:BIB_785FD2E6A988
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
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
The Lancet. Neurology
Working group(s)
GBD 2021 Stroke Risk Factor Collaborators
Contributor(s)
Abate M.D., Abate Y.H., Abd ElHafeez S., Abd-Allah F., Abdelalim A., Abdelkader A., Abdelmasseh M., Abd-Elsalam S., Abdi P., Abdollahi A., Abdoun M., Abd-Rabu R., Abdulah D.M., Abdullahi A., Abebe M., Abeldaño Zuñiga R.A., Abhilash E.S., Abiodun O.O., Abiodun O., Abo Kasem R., Aboagye R.G., Abouzid M., Abreu L.G., Abrha W.A., Abtahi D., Abu Rumeileh S., Abualhasan A., Abualruz H., Abu-Gharbieh E., Abukhadijah H.J., Abu-Rmeileh N.M., Aburuz S., Abu-Zaid A., Acuna J.M., Adane D.E., Adane M.M., Addo I.Y., Adedoyin R.A., Adegboye O.A., Adekanmbi V., Adhikari K., Adnani QES, Adra S., Adzigbli L.A., Afify A.Y., Afolabi A.A., Afrashteh F., Afzal M.S., Afzal S., Aghamiri S., Agyemang-Duah W., Ahinkorah B.O., Ahmad A., Ahmad M.M., Ahmad S., Ahmad S., Ahmad T., Ahmadzade A.M., Ahmed A., Ahmed A., Ahmed H., Ahmed S.A., Ajami M., Aji B., Akara E.M., Akinyemi R.O., Akkaif M.A., Akrami A.E., Al Awaidy S., Al Hamad H., Al Hasan S.M., Al Qadire M., Al Ta'ani O., Al-Ajlouni Y., Alalalmeh S.O., Alalwan T.A., Al-Aly Z., Al-Amer R.M., Aldhaleei W.A., Aldossary M.S., Alemohammad S.Y., Al-Fatly B., Al-Gheethi AAS, Alhalaiqa F.N., Alharrasi M., Ali A., Ali M.U., Ali R., Ali S.S., Ali W., Al-Ibraheem A., Alif S.M., Aljunid S.M., Almahmeed W., Al-Marwani S., Alomari M.A., Alonso J., Alqahtani J.S., Al-Raddadi RMM, Alrawashdeh A., Alsabri M.A., Alshahrani N.Z., Altaany Z., Altaf A., Al-Tammemi A.B., Altwalbeh D., Alvis-Guzman N., Alwafi H., Al-Wardat M., Al-Worafi Y.M., Aly H., Aly S., Alyahya MSI, Alzoubi K.H., Al-Zyoud W.A., Amani R., Amegbor P.M., Amera T.G., Amin T.T., Amindarolzarbi A., Amiri S., Amu H., Amugsi D.A., Amusa G.A., Ancuceanu R., Anderlini D., Angappan D., Anil A., Ansari MTT, Ansari-Moghaddam A., Ansong R., Anvari S., Anwar S., Anwar S.L., Anyabolo E.E., Anyasodor A.E., Apostol GLC, Appiah F., Aqeel M., Arabloo J., Arabzadeh Bahri R., Arafat M., Aravkin A.Y., Ardekani A., Areda D., Aregawi B.B., Aregu G.M., Aremu O., Arifin H., Ärnlöv J., Artamonov A.A., Arulappan J., Aryal U.R., Aryan Z., Asbeutah A.M., Asemahagn M.A., Asemu M.T., Asghari-Jafarabadi M., Ashemo M.Y., Ashraf T., Aslani A., Asmerom H.A., Astell-Burt T., Athari S.S., Atorkey P., Atout MMW, Atreya A., Aujayeb A., Ausloos M., Avan A., Awad H., Awotidebe A.W., Ayana LAA, Aychiluhm S.B., Aynalem A.A., Aynalem Z.B., Azadnajafabad S., Azami H., Aziz S., Azzam A.Y., Babu A.S., Babu G.R., Badar M., Badiye A.D., Bahrami Taghanaki P., Bahramian S., Bai R., Baig A.A., Bakkannavar S.M., Bako A.T., Baltatu O.C., Bam K., Banach M., Banakar M., Bandyopadhyay S., Banik P.C., Bansal K., Bao Y., Barboza M.A., Bardhan M., Barengo N.C., Barker-Collo S.L., Bärnighausen T.W., Barqawi H.J., Barrow A., Barua L., Bashiri A., Bashiru H.A., Basiru A., Bastan M.M., Basu S., Basu S., Batra K., Begde A., Behnam B., Behnoush A.H., Belayneh MBY, Belingheri M., Bello U.M., Bennett D.A., Bensenor I.M., Berhe F.T., Bermudez ANC, Beyene HBB, Beyene K.A., Bhagat D.S., Bhagavathula A.S., Bhala N., Bhalla A., Bhardwaj N., 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E., Gholami Z., Ghozy S., Giannoni Luza S., Gilani J.A., Gill T.K., Gillum R.F., Gindaba E.Z., Gnedovskaya E.V., Goel A., Goldust M., Golechha M., Goleij P., Golinelli D., Gona P.N., Gorini G., Goulart A.C., Goulart BNG, Gouravani M., Grivna M., Grosso G., Grover A., Guan S.Y., Guarducci G., Guha A., Guicciardi S., Gulati S., Gunawardane D.A., Guo C., Guo Z., Gupta A.K., Gupta B., Gupta M., Gupta R., Gupta R.D., Gupta R., Gupta S., Habibzadeh F., Hadi N.R., Haghani Dogahe M., Haghi-Aminjan H., Haghmorad D., Haj-Mirzaian A., Halimi A., Hamdy N.M., Hamidi S., Hamilton E.B., Hanif A., Hanifi N., Hankey G.J., Hannan M.A., Haq Z.A., Hargono A., Harlianto N.I., Haro J.M., Has EMM, Hasaballah A.I., Hasan I., Hasnain M.S., Hassan I., Hassan Zadeh Tabatabaei M.S., Haubold J., Havmoeller R.J., Hay S.I., Hbid Y., Hebert J.J., Hegazi O.E., Heidari M., Hemmati M., Heyi D.Z., Hezam K., Hiraike Y., Hoan N.Q., Holla R., Horita N., Hossain M.M., Hosseinzadeh H., Hosseinzadeh M., Hosseinzadeh Adli A., 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E.A., Mehmood A., Mehrabani-Zeinabad K., Mekene Meto T., Meles H.N., Mendoza W., Menezes R.G., Mensah G.A., Meo S.A., Meretoja A., Meretoja T.J., Mestrovic T., Mettananda CDK, Miazgowski T., Michalek I.M., Micheletti Gomide Nogueira de Sá A.C., Minervini G., Minh LHN, Mini G.K., Mirghafourvand M., Mirica A., Mirrakhimov E.M., Mirza-Aghazadeh-Attari M., Mishra M., Misra S., Mithra P., Mohamed A.I., Mohamed J., Mohamed N.S., Mohammad A.M., Mohammadi E., Mohammadi S., Mohammadi S., Mohammadian-Hafshejani A., Mohammadzadeh I., Mohammed H., Mohammed M., Mohammed S., Mohammed S., Mokdad A.H., Molavi Vardanjani H., Molokhia M., Momani S., Monasta L., Moni M.A., Montazeri F., Moodi Ghalibaf A., Moosazadeh M., Moradi M., Moradi Y., Moraga P., Morawska L., Moreira R.S., Morrison S.D., Mosaddeghi Heris R., Mossialos E., Mousavi P., Msherghi A., Mubarik S., Muccioli L., Mulita A., Muniyandi M., Munjal K., Murillo-Zamora E., Muthu S., Myung W., Nabavi A., Nabhan A.F., Nafei A., Nagarajan A.J., 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Saber-Ayad M.M., Sabet C.J., Sabour S., Sacco S., Saddik B.A., Sadeghi E., Saeb M.R., Saeed U., Safi SZZ, Sagar R., Saghafi A., Sagoe D., Saheb Sharif-Askari F., Sahebkar A., Sahoo P.M., Sahoo S.S., Sajid M.R., Salami A.A., Salaroli L.B., Saleh M.A., Salem MZY, Salum G.A., Samadzadeh S., Samargandy S., Samodra Y.L., Samuel V.P., Samy A.M., Sanabria J., Santos I.S., Santric-Milicevic M.M., Sarasmita M.A., Saravanan A., Sarikhani Y., Sarode G.S., Sarode S.C., Satpathy M., Sattouf Z., Saya G.K., Sayeed M.A., Sayyah M., Scarmeas N., Schaarschmidt B.M., Schlaich M.P., Schmidt M.I., Schneider IJC, Schuermans A., Schumacher A.E., Schutte A.E., Schwebel D.C., Selvaraj S., Sen P., Senapati S., Senthilkumaran S., Sergindo M.T., Sethi Y., Seylani A., Shafie M., Shah P.A., Shahabi S., Shahbandi A., Shahid S., Shahsavari H.R., Shahwan M.J., Shaikh M.A., Shalash A.S., Shamim M.A., Shams-Beyranvand M., Shamsi A., Shamsutdinova A., Shanawaz M., Shannawaz M., Sharath M., Sharifan A., Sharifi A., Sharifi-Rad J., Sharma A., Sharma M., Sharma S., Sharma U., Sharma V., Sheikhi R.A., Shetty A., Shetty M., Shetty P.K., Shiferaw D., Shigematsu M., Shimels T., Shin M.J., Shiri R., Shittu A., Shitu A.O., Shiue I., Shorofi S.A., Shrestha S., Shuval K., Si Y., Siddig E.E., Sikdar M., Silva J.P., Silva LMLR, Singh A., Singh B., Singh G., Singh H., Singh J.A., Singh K., Singh N.P., Singh P., Singh P., Sipilä JOT, Sivakumar S., Skryabin V.Y., Skryabina A.A., Sleet D.A., Sobia F., Socea B., Sohag AAM, Solanki R., Solanki S., Solomon Y., Song Y., Soraneh S., Sorensen RJD, Sotoudeh H., Soyiri I.N., Spartalis M., Sreeramareddy C.T., Srinivasamurthy S.K., Stachteas P., Stafford L.K., Stark B.A., Starodubova A.V., Subedi N., Subramaniyan V., Suleman M., Sultana A., Sun Z., Sundström J., Suresh V., Susanty S., Swain C.K., Szarpak L., T Y S.S., Tabaee Damavandi P., Tabarés-Seisdedos R., Tabatabaei S.M., Tabatabai S., Tabche C., Tabish M., Tadakamadla J., Tadakamadla S.K., Taheri A., Taiba J., Talaat I.M., Talukder A., Tampa M., Tamuzi J.L., Tan K.K., Tang H., Tanwar M., Tarigan I.U., Tarkang E.E., Tat N.Y., Tavangar S.M., Tehrani-Banihashemi A., Teimoori M., Temsah M.H., Temsah RMH, Teramoto M., Tesfamariam W.B., Tesfaye Gta E.G., Thakur R., Thangaraju P., Thapa R., Thapar R., Thayakaran R., Thirunavukkarasu S., Thomas J., Thomas NKK, Thrift A.G., Tian J., Tichopad A., Ticoalu JHV, Tiruneh C., Tiwari K., Tiyuri A., Tonelli M., Topor-Madry R., Tovani-Palone M.R., Trabelsi K., Tran N.H., Tran T.H., Tran Minh Duc N., Trico D., Tromans S.J., Truyen TTTT, Tsai D.H., Tsatsakis A., Tsermpini E.E., Turuse EAA, Tyrovolas S., Udoakang A.J., Udoh A., Ullah A., Ullah S., Umair M., Umar M., Unim B., Unnikrishnan B., Urso D., Usman J.S., Vacante M., Vahabi S.M., Vahdati S., Vaithinathan A.G., Vakili O., Valizadeh R., Van den Eynde J., Varga O., Varthya S.B., Vasankari T.J., Vellingiri B., Venketasubramanian N., Verma M., Veroux M., Verras G.I., Vervoort D., Villafañe J.H., Villani S., Vinayak M., Viskadourou M., Volovat S.R., Volovici V., Wafa H.A., Waheed Y., Wahood W., Wang C., Wang F., Wang S., Wang S., Wang Y., Wang Y.P., Wanjau M.N., Waqas M., Wassie E.G., Wassie G.T., Wei Z., Weintraub R.G., Weldetinsaa H.L., Wickramasinghe D.P., Wickramasinghe N.D., Wijeratne T., Willeit P., Wolfe CDA, Wong Y.J., Wongsin U., Wu C., Wu F., Wu Y., Wu Z., Xiao H., Xu S., Xu X., Yamagishi K., Yang D., Yano Y., Yarahmadi A., Yaribeygi H., Yasufuku Y., Yatsuya H., Yazdanpanah F., Yazdanpanah M.H., Ye P., Yesodharan R., Yezli S., Yi S., Yi X., Yin D., Yon D.K., Yonemoto N., Yu C., Yu E.A., Yun K., Yusuf H., Zadey S., Zafari N., Zaman B.A., Zaman S.B., Zanghì A., Zare I., Zarimeidani F., Zarrintan A., Zastrozhin M., Zemedikun D., Zeng Y., Zhang B., Zhang H., Zhang L., Zhang Y., Zhang Z., Zhao H., Zhong C.C., Zhou S.C., Zhu B., Zhu L., Zhumagaliuly A., Ziafati M., Zielińska M., Zikarg Y.T., Zoghi G., Zyoud S.H., Zyoud S.H., Johnson C.O., Roth G.A., Nair B.S., Rautalin I., Bhati A., Bisignano C., Vos T., Murray CJL
ISSN
1474-4465 (Electronic)
ISSN-L
1474-4422
Publication state
Published
Issued date
10/2024
Peer-reviewed
Oui
Volume
23
Number
10
Pages
973-1003
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
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.
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.
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]).
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.
Bill & Melinda Gates Foundation.
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.
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]).
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.
Bill & Melinda Gates Foundation.
Keywords
Humans, Global Burden of Disease, Risk Factors, Stroke/epidemiology, Global Health, Disability-Adjusted Life Years, Incidence, Prevalence, Quality-Adjusted Life Years, Male, Female
Pubmed
Open Access
Yes
Create date
30/09/2024 11:23
Last modification date
01/10/2024 6:07
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