Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21460%2F24%3A00377352" target="_blank" >RIV/68407700:21460/24:00377352 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.1016/S1474-4422(24)00369-7" target="_blank" >https://doi.org/10.1016/S1474-4422(24)00369-7</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/S1474-4422(24)00369-7" target="_blank" >10.1016/S1474-4422(24)00369-7</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Popis výsledku v původním jazyce

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. Funding: Bill & Melinda Gates Foundation. 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Název v anglickém jazyce

Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Popis výsledku anglicky

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. Funding: Bill & Melinda Gates Foundation. 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30302 - Epidemiology

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Lancet Neurology

ISSN

1474-4422

e-ISSN

1474-4465

Svazek periodika

23

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

31

Strana od-do

973-1003

Kód UT WoS článku

001366062900001

EID výsledku v databázi Scopus

2-s2.0-85203982941