The Lancet Neurology journal has published estimates indicating a significant increase in the incidence of stroke and related deaths worldwide. This rise is driven by factors such as air pollution, high temperatures, and metabolic risk factors like high blood pressure and physical inactivity.
According to researchers, high temperatures have contributed to a 72% increase in poor health and early death due to stroke since 1990, and this trend is expected to continue in the future. This underscores the impact of environmental factors on the growing burden of stroke.
Additionally, the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) group found that particulate matter (PM) air pollution now has the same impact as smoking in causing a fatal form of brain bleed, marking the first time such a correlation has been identified.
The GBD study, the "largest and most comprehensive effort to quantify health loss across places and over time," is coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, US.
Globally, the incidence of first-time stroke cases increased to 119 million in 2021, marking a 70 per cent rise since 1990. Meanwhile, stroke-related deaths reached 73 million, showing a 44 per cent increase since 1990. This has positioned the neurological condition as the third leading cause of death, following ischaemic heart disease and COVID-19, according to researchers.
The researchers noted that more than three-quarters of stroke cases occur in low- and middle-income countries.
Lead author Valery L Feigin from Auckland University of Technology, New Zealand, stated that the substantial increase in the number of people affected by stroke strongly indicates that the current stroke prevention strategies are not sufficiently effective.
"New, proven effective population-wide and motivational individual prevention strategies that could be applied to all people at risk of having a stroke, regardless of the level of risk, as recommended in the recent Lancet Neurology Commission on Stroke should be implemented across the globe urgently," said Feigin.
The researchers also estimated that stroke-related liabilities attributable to 23 modifiable risk factors, including air pollution, excess body weight, high blood pressure, smoking and physical inactivity, increased from 100 million years of healthy life lost in 1990 to 135 million in 2021.
These risk factors are present in huge numbers in Eastern Europe, Asia and sub-Saharan Africa, they said.
The authors also acknowledged substantial progress made in reducing the global stroke burden from risk factors linked to poor diet, air pollution and smoking.
They found that poor health resulting from diets high in processed meat and low in vegetables declined by 40 per cent and 30 per cent, respectively, while that due to PM air pollution and smoking fell by 20 per cent and 13 per cent, respectively.
The authors said the results suggested that strategies for reducing exposure to these risk factors over the past three decades, such as clean air zones and public smoking bans, have been successful.
They called for implementing and monitoring the evidence-based recommendations set out in the 2023 World Stroke Organisation-Lancet Neurology Commission on stroke for drastically reducing the global burden of stroke in the years to come and improving brain health and overall well-being of millions of people around the world.
The recommendations include stroke surveillance programmes that monitor indicators of stroke such as incidence, recurrence, death rates and risk factors in a country, and care and rehabilitation services for people affected by stroke.
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