Global, regional, and national burden of stroke and its risk factors, 1990–2019
A systematic analysis for the Global Burden of Disease Study 2019
Bibliographic Data
BACKGROUND: Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. METHODS: We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FINDINGS: In 2019, there were 12·2 million (95% UI 11·0-13·6) incident cases of stroke, 101 million (93·2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6·55 million (6·00-7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8-12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1-6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0-73·0), prevalent strokes increased by 85·0% (83·0-88·0), deaths from stroke increased by 43·0% (31·0-55·0), and DALYs due to stroke increased by 32·0% (22·0-42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0-18·0), mortality decreased by 36·0% (31·0-42·0), prevalence decreased by 6·0% (5·0-7·0), and DALYs decreased by 36·0% (31·0-42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0-24·0) and incidence rates increased by 15·0% (12·0-18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5-3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5-3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57-8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97-3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01-1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7-90·8] DALYs or 55·5% [48·2-62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3-48·6] DALYs or 24·3% [15·7-33·2]), high fasting plasma glucose (28·9 million [19·8-41·5] DALYs or 20·2% [13·8-29·1]), ambient particulate matter pollution (28·7 million [23·4-33·4] DALYs or 20·1% [16·6-23·0]), and smoking (25·3 million [22·6-28·2] DALYs or 17·6% [16·4-19·0]). INTERPRETATION: The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. FUNDING: Bill & Melinda Gates Foundation.
Burden of disease · Disease · Disease burden · Environmental health · Stroke (engine) · Acute Ischemic Stroke Management · Engineering · Internal Medicine · Intracerebral and Subarachnoid Hemorrhage Research · Medicine · Stroke Rehabilitation and Recovery
The mediating effect of depression on the association between grip strength-to-weight ratio and stroke in middle-aged and older adults
Application of machine learning and natural language processing for predicting stroke-associated pneumonia
Probability of Stroke in Blacks and Non-Hispanic Whites Treated with ACE-I, ARBs, and Other Antihypertensives
Práticas da terapia ocupacional na reabilitação Pós-AVC
Linha De Cuidado De Avc No Amazonas
Multiple mediators of anxiety and depression between living space and cognitive function among elderly patients with ischemic stroke
A higher burden of post-stroke depression and anxiety and their predictors among stroke survivors in the Amhara Regional State, Ethiopia, in 2024
Association between Heat Vulnerability Index and Stroke Severity
The Effects of Meditation with Stabilization Exercise in Marine Region on Pain, Tactile Sense, Muscle Characteristics and Strength, Balance, Quality of Life, and Depression in Female Family Caregivers of People with Severe Physical Disabilities
Quantitative Evaluation of Postural SmartVest’s Multisensory Feedback for Affordable Smartphone-Based Post-Stroke Motor Rehabilitation
Association between Stroke and Abdominal Obesity in the Middle-Aged and Elderly Korean Population
Medication Literacy in Chinese Patients with Stroke and Associated Factors
The Use of Cardiac Autonomic Responses to Aerobic Exercise in Elderly Stroke Patients
Effects of Coaching-Based Teleoccupational Guidance for Home-Based Stroke Survivors and Their Family Caregivers
Dietary Minerals and Incident Cardiovascular Outcomes among Never-Smokers in a Danish Case–Cohort Study
National and Regional Rates of Chronic Diseases and All-Cause Mortality in Saudi Arabia—Analysis of the 2018 Household Health Survey Data
Predictive Model and Mortality Risk Score during Admission for Ischaemic Stroke with Conservative Treatment
Struck by stroke - experiences of living with stroke in a rural area in Uganda
Spatial and temporal patterns of disease burden attributable to high BMI in Belt and Road Initiative countries, 1990–2019
Association between population hypertension control and ischemic heart disease and stroke mortality in 36 countries of the Americas, 1990-2019
Asociación entre el control de la hipertensión arterial en la población y la mortalidad por cardiopatía isquémica y accidente cerebrovascular en 36 países y territorios de la Región de las Américas, 1990-2019
Mortalidade cerebrovascular
The prevalence and factors associated with neck and low back pain in patients with stroke
Burden of neurological diseases in Asia, from 1990 to 2021 and its predicted level to 2045
Unveiling China’s heart disease challenges
Temporal trends of the burden of ischemic stroke attributable to high low-density lipoprotein cholesterol in China from 1999 to 2019
Efficacy of short message service (SMS) intervention on medication adherence and knowledge of stroke prevention among clinic attendees at risk of stroke
The impact of DRG payment reform on stroke inpatient costs
Global burden of disease analysis of stroke due to high systolic blood pressure in different regions, 1990–2021
World Stroke Organization (WSO)
Heart Disease and Stroke Statistics—2023 Update
Global, regional, and national burden of disorders affecting the nervous system, 1990–2021
Association between climatic variables and cardiovascular hospitalizations in Brazil
The effect of high-intensity interval training on cardiorespiratory fitness for non-ambulatory stroke survivors
Analysis and prediction of subarachnoid hemorrhage burden in global, China, and Japan
The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression
Temporal Trend of the Prevalence of Modifiable Risk Factors of Stroke
Association between the weight-adjusted waist index and stroke
Effect of the Covid-19 Pandemic in the Prehospital Management of Patients with Suspected Acute Stroke
Epidemiological trends and age-period-cohort effects on ischemic stroke burden across the BRICS-plus from 1992 to 2021
Patterns of global burden of 13 diseases attributable to lead exposure, 1990–2019
Clinical Features to Predict the Use of a sEMG Wearable Device (Remo®) for Hand Motor Training of Stroke Patients
Cleaner outdoor air diminishes the overall risk of intracerebral hemorrhage but brings differential benefits to subpopulations
Predictive models for delay in medical decision-making among older patients with acute ischemic stroke
How can i think of stroke when i don’t even have money to eat
Association of pulmonary function with the risk of stroke based on the NHANES database
Females with diabetes have a higher risk of ischemic stroke readmission
Stroke attributed to kidney dysfunction from 1990 to 2021 and the prediction for 2040
Differential Factors Are Associated with Physical Activity in Older Adults in Brazil with and without Non-Communicable Chronic Diseases
Physical and Psychological Symptoms After Stroke
A Bibliometric Analysis of Stroke Caregiver Research from 1989 to 2022
Traditional Chinese medicine interventions for post-stroke emotional disorders
Cognitive and emotional benefits of individual reminiscence therapy in elderly stroke survivors
Association between sleep behaviors and stroke in Southwest China
Influencing factors of home exercise adherence in elderly patients with stroke
Factors influencing the caregiver burden on primary family caregivers of stroke survivors
Carotid Plaque Features and Inflammatory Biomarkers as Predictors of Restenosis and Mortality Following Carotid Endarterectomy
Association of ambient temperature on acute ischemic stroke in Yancheng, China
Prevalence and characteristics of comorbid stroke and traumatic brain injury in a real-world population
Spatial-temporal variations of stroke mortality worldwide from 2000 to 2021
Stroke recurrence, uncertainty in illness, and self-efficacy as predictors of post-stroke depression in Korean survivors
Association between Anemia Severity and Ischemic Stroke Incidence
Psychological outcomes and changes in health-related quality of life in young and middle-aged patients with first-onset stroke after rehabilitation training
Trends in deaths and disability-adjusted life-years of stroke attributable to low physical activity worldwide, 1990–2019
Global, regional, and national impact of air pollution on stroke burden
The impact of alcohol consumption on stroke prognosis
Factors associated with Sars-CoV-2 vaccine hesitancy after stroke
Psychological status on informal carers for stroke survivors at various phases
Epidemiological shifts in chronic kidney disease
The Feasibility of Make My Day—A Randomized Controlled Pilot Trial of a Stroke Prevention Program in Primary Healthcare
The 2019 national health survey
A cross-sectional study on post-stroke depression and the quality of life
Global trends and regional differences in disease burden of stroke among children
Spousal bereavement and depression
Latent class analysis and longitudinal development trajectory study of psychological distress in patients with stroke
Investigation of the relationship between lead exposure in heavy metals mixtures and the prevalence of stroke
The effect of social alienation on stigma among stroke inpatients in China
Association between healthy lifestyle on life course and multimorbidity in adults
Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings
Spatiotemporal analysis of hospitalizations, mortality and access to intravenous thrombolysis for ischemic stroke in Southern Brazil
Comparative analysis of stroke burden between ages 20–54 and over 55 years
Increased Risk of Developing Depression in Disability after Stroke
The relationship between psychological distress and frailty in stroke patients
Trajectories and influencing factors of social alienation in first-onset stroke patients
Development and Validation of a Novel Score for Predicting Long-Term Mortality after an Acute Ischemic Stroke
Global burden of stroke in adolescents and young adults (aged 15–39 years) from 1990 to 2019
From smoke to stroke
Economic burden of stroke attributable to excess body mass in Hungary
Depression status and functional outcome of patients with ischemic stroke and the impact on caregivers living in Chengdu
An actor-partner interdependence mediation model for assessing the association between dyadic coping and post-traumatic growth in dyads of patients with stroke and their spouses
Relationships between Self-Efficacy and Post-Stroke Activity Limitations, Locomotor Ability, Physical Activity, and Community Reintegration in Sub-Saharan Africa
The status of readiness for hospital discharge of patients with post-stroke cognitive impairment and its relationship with post-discharge social isolation
The effect of aromatherapy on post-stroke depression
Trend analysis of stroke subtypes mortality attributable to high body-mass index in China from 1990 to 2019
Association between percentage of smokers and prevalence of smoking attributable morbidity in Indonesia
Assessment of Health-Related Quality of Life of Stroke Survivors in Southeast Communities in Nigeria
Global burden and cross-country inequalities in stroke and subtypes attributable to diet from 1990 to 2019
A UK national cross-sectional survey of stroke support groups
Global, regional and national burden of stroke and subtypes burden in women of reproductive age
Study on the prediction model of atherosclerotic cardiovascular disease in the rural Xinjiang population based on survival analysis
The Epidemiologic Transition
Prevalence, Incidence, and Mortality of Stroke in China
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017
Global burden of stroke and risk factors in 188 countries, during 1990–2013
Global Prevalence of Diabetes
Measuring the Global Burden of Disease
Five insights from the Global Burden of Disease Study 2019
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017
Global, regional, and national disability-adjusted life-years (Dalys) for 359 diseases and injuries and healthy life expectancy (Hale) for 195 countries and territories, 1990–2017
Global and Regional Effects of Potentially Modifiable Risk Factors Associated With Acute Stroke in 32 Countries (Interstroke)
Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015
Global, regional, and national burden of stroke, 1990–2016
Global burden of 87 risk factors in 204 countries and territories, 1990–2019
Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019
Gender Differences in Hypertension and Hypertension Awareness Among Young Adults
| Unique citing works | 231 |
|---|---|
| Citations per year | 46,2 |
| Citation span | 2021 - 2026 (6) |
| Citation velocity | current |
| Highly cited | Yes |
| Citation types | Neutral: 209 |