Global burden, risk factor analysis and prediction study of ischemic stroke, 1990–2030
Summary
Purpose:
Ischemic stroke ( IS), one of the two main subtypes of stroke, occurs due to cerebral ischemia as a result of thrombosis of a cerebral blood vessel. Ischemic stroke (IS) is one of the most important neurovascular causes of death and disability. It is affected by many risk factors, such as smoking and high body mass index (BMI), which are also critical in the preventive control of other cardiovascular and cerebrovascular diseases. However, there are still few systematic analyzes of the current and projected disease burden as well as risk factors attributable to ischemic stroke.
Methods:
Based on the GBD2019 database, we used age-standardized mortality rate (ASMR) and disability-adjusted life year (ASDR) to systematically present the geographic distribution and trends of disease burden of ischemic stroke in worldwide from 1990 to 2019 by calculating the estimated annual rate of percentage change (EAPC), and to analyze and predict the number of IS deaths represented by seven major risk factors for 2020-2030.
Results:
Between 1990 and 2019, the global number of deaths from IS increased from 2.04 million to 3.29 million and is expected to further increase to 4.90 million by 2030. The downward trend was most pronounced in women, young and high sociodemographic index (SDI) regions.
At the same time, a study of attributable risk factors for IS found that two behavioral factors, smoking and high-sodium diet , and five metabolic factors, including high systolic blood pressure, high low-density lipoprotein cholesterol, Renal dysfunction, rapidly high plasma glucose and high BMI are major contributors to the increasing disease burden of ischemic stroke (IS) now and in the future.
Conclusions: Our study provides the first comprehensive summary of the last thirty years and prediction of the global burden of ischemic stroke (IS) and its attributable risk factors through 2030, providing detailed statistics for decision-making on stroke prevention and control. YES worldwide. Inadequate control of the seven risk factors would lead to a higher disease burden of ischemic stroke (IS) in young people, especially in low-SDI regions. Our study identifies high-risk populations and helps public health professionals develop targeted preventive strategies to reduce the global disease burden of ischemic stroke. |
Comments
Deaths from ischemic strokes increased by more than 1 million between 1990 and 2019
The number of deaths worldwide from ischemic stroke increased from 2 million in 1990 to more than 3 million in 2019, and is expected to rise to nearly 5 million by 2030 , according to a study published in the issue in Neurology , the journal physician of the American Academy of Neurology. The study focused on ischemic stroke, which is caused by a blockage of blood flow to the brain and is the most common type of stroke.
"This increase in the number of global deaths from ischemic stroke coupled with a greater increase expected in the future is concerning, but ischemic stroke is highly preventable," said study author Lize Xiong, MD, of the University of Tongji in Shanghai, China. "Our results suggest that a combination of lifestyle factors such as smoking and a high-sodium diet along with other factors such as high blood pressure and high body mass index may lead to an increased risk of stroke."
For the study, researchers analyzed data from the Global Health Data Exchange from 1990 to 2019. As the world’s population grew, the global number of deaths from ischemic strokes increased from 2.04 million in 1990 to 3.29 million in 2019. However, the stroke rate decreased from 66 strokes per 100,000 people in 1990 to 44 strokes per 100,000 people in 2019.
"This decrease in the rate of stroke probably means that the overall increase in the number of strokes around the world is mainly due to population growth and aging," Xiong said.
The researchers found that seven major risk factors, including smoking, a high-sodium diet, high blood pressure, high cholesterol, kidney dysfunction, high blood sugar and a high BMI, contributed to the most strokes.
The researchers then used the database to predict the number of deaths for 2020-2030. They found that the number of deaths from ischemic stroke is expected to further rise to 4.9 million in 2030. When researchers took risk factors into account, they predicted that the total number of stroke deaths could reach 6. 4 million if these risk factors are not controlled.
“This study provides an insightful perspective on the global burden of ischemic stroke,” said editorial author Carlos Cantú-Brito, MD, PhD, of the Stroke Clinic at the National Institute of Health Sciences and Nutrition Salvador Zubirán in the Mexico City, Mexico. “It points out many vital factors that should be used for informed policymaking, emphasizing the need for policies and programs to promote healthy lifestyles, including regular physical activity, low-salt diets and smoking cessation.”
A limitation of the study was that the quality and accuracy of disease data from some countries cannot be guaranteed, as many did not have reliable information on stroke.
The study was supported by the Ministry of Science and Technology of China, the Shanghai Fourth People’s Hospital, the National Key Research and Development Program of China, and the Shanghai Nature Science Foundation.
