Global Trends and Cross-Country Inequalities in Stroke and Subtypes Attributable to High Body Mass Index From 1990 to 2021.

Abstract

Background: Stroke is a major global cause of death and disability, with high body mass index (HBMI) as a key modifiable risk factor. Understanding HBMI-attributable stroke burden is crucial for effective prevention.

Methods and results: Using Global Burden of Disease 2021 data, we analyzed disability-adjusted life years and mortality from stroke and its subtypes (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage) attributable to HBMI at global, regional, and national levels from 1990 to 2021. We conducted decomposition, frontier, inequality, and predictive analyses to assess epidemiological trends and future projections up to 2035. Despite country-specific variations in disability-adjusted life years and mortality, the global burden of stroke and its subtypes attributable to HBMI has increased from 1990 to 2021. Frontier analysis indicated that countries with higher sociodemographic index were expected to own lower age-standardized rates for stroke and its subtypes attributable to HBMI. Decomposition analysis revealed that population growth and aging were the primary contributors to the rise. Significant cross-country disparities remained, although inequality analysis showed a decline in SDI-related differences over time. The projected annual rise in disability-adjusted life years and mortality from 2021 to 2035 suggested ongoing significant challenges in stroke control and management in the coming decades.

Conclusion: The global health challenge posed by the increasing burden of stroke and its subtypes attributable to HBMI remains significant, especially in low- and middle-sociodemographic index regions. Targeted lifestyle modifications and policy interventions are crucial for reducing HBMI and mitigating stroke burden, warranting special attention from policymakers in high-burden regions.