Global burden of disease study highlights the global, regional and national trends of stroke.

Abstract

Background: Stroke remains a significant global health challenge, especially in low- and middle-income countries, despite advances in treatment and prevention. Understanding stroke trends is crucial for guiding prevention and healthcare strategies.

Methods: We analysed global data from the Global Burden of Disease Study 2021 on stroke incidence, prevalence, disability-adjusted life years and mortality from 1990 to 2021. The study focused on the major subtypes of stroke-ischaemic stroke (IS), intracerebral haemorrhage and subarachnoid haemorrhage-examining the effects of age, sex and sociodemographic index (SDI) on stroke outcomes. Decomposition analysis assessed the contributions of population growth, ageing and other factors to stroke burden. The Nordpred Prediction Model was used to forecast stroke trends from 2022 to 2046.

Results: From 1990 to 2021, global stroke incidence and deaths increased by 70.20% and 32.17%, respectively, driven by population ageing (45.3%) and growth (29.1%). However, age-standardised incidence and mortality rates declined by 21.78% and 39.10%, reflecting improvements in healthcare and risk factor control. IS saw the largest increase in crude incidence (87.97%), with regional disparities, especially in low-SDI countries. By 2046, global stroke incidence and mortality are projected to rise by 20.3% and 35.7%, primarily in low- and middle-SDI countries.

Conclusions: The global stroke burden is rising, particularly in low-SDI regions, due to ageing and population growth. Declines in age-standardised rates emphasise the importance of healthcare improvements. Region-specific strategies are needed to address the rising burden and reduce disparities in stroke outcomes.