Abstract Body: OBJECTIVES
To provide standardized, comprehensive, and updated estimates of the global, regional, national burden and risk factors for ischemic stroke (IS) in adults.
Method
This was a population-based study (Global Burden of Disease, Injuries and Risk Factors Study 2021), including adults aged 20 years and older from 1990 to 2021. The primary outcomes were IS related age-standardized prevalence, mortality, disability-adjusted life years (DALYs) rates, and risk factors associated with DALYs.
RESUTS
From 1990-2021, the global age-standardized prevalence of IS decreased from 1,309 to 1,266 per 100,000 population (AAPC, -0.12% [95%UI, -0.13 to -0.10]). However, the prevalence increased notably in middle-socio-demographic index (SDI) regions and in East Asia, while remained stable in southeast Asia. The caseload of IS still rose significantly from 33.2 [29.2-37.5] to 68.4 [60.5-76.8] million. The overall age-standardized mortality for IS declined from 116 to 70 per 100,000 population (AAPC, -1.60%). The overall age-standardized DALYs rates for IS decreased by 35% (AAPC, -1.36%). The decline in both the age-standardized mortality and DALYs rates was correlated with the SDI, with the most rapid decrease occurring in high-SDI regions. Conversely, in subregions of southern Sub-Saharan Africa, an increase was observed. Males consistently faced a greater burden of IS across all subgroups. High systolic blood pressure and high low-density lipoprotein cholesterol (LDL-C) levels consistently represented the most significant risk factors contributing to DALYs from 1990- 2021.
CONCLUSIONS
While the age-standardized prevalence, mortality and DALYs rates for IS have declined globally, the total caseload has increased. Lower SDI regions, particularly in southern sub-Saharan Africa and East Asia, still confront considerable obstacles in alleviating the burden of IS. Managing high systolic blood pressure and high LDL-C levels, and mitigating the increased risk among males remain critical clinical challenges for adults with IS.