Global, Regional and Country-Specific Burden of Ischaemic Stroke, Intracerebral Haemorrhage and Subarachnoid Haemorrhage: A Systematic Analysis of the Global Burden of Disease Study 2017

Abstract

<b><i>Background:</i></b> Stroke is a leading cause of death and disability in globally and particularly in low- and middle-income countries, and this burden is increasing. The burden of stroke pathological subtypes varies in terms of incidence, disability and mortality. Previous Global Burden of Diseases, Injuries, and Risk Factors Studies (GBD) reports did not provide separate global burden and trends estimates for haemorrhagic stroke by primary intracerebral haemorrhage (PICH) and subarachnoid haemorrhage (SAH). <b><i>Aim:</i></b> To summarise the GBD 2017 findings for the burden and 27-year trends for ischaemic stroke (IS), intracerebral haemorrhage and SAH by age, sex and country income level in 21 world regions and associated risk factors. <b><i>Methods:</i></b> Data on stroke incidence, prevalence, mortality and disability-adjusted life-years (DALY) lost and the burden of IS, PICH and SAH were derived from all available datasets from the GBD 2017 studies. Data were analysed in terms of absolute numbers and age-standardised rates per 100,000 (95% uncertainty interval [UI]), with estimates stratified by age, sex and economic development level by the World Bank classification. We also analysed changes in the patterns of incidence, mortality and DALYs estimates between 1990 and 2017. <b><i>Results:</i></b> In 2017, there were 11.9 million incident (95% UI 11.1–12.8), 104.2 million prevalent (98.6–110.2), 6.2 million fatal (6.0–6.3) cases of stroke and 132.1 million stroke-related DALYs (126.5–137.4). Although stroke incidence, prevalence, mortality and DALY rates declined from 1990 to 2017, the absolute number of people who developed new stroke, died, survived or remained disabled from stroke has almost doubled. The bulk of stroke burden (80% all incident strokes, 77% all stroke survivors, 87% of all deaths from stroke and 89 of all stroke-related DALYs) in 2017 was in low- to middle-income countries. Globally in 2017, IS constituted 65%, PICH –26% and SAH –9% of all incident strokes. <b><i>Discussion:</i></b> The latest GBD estimates of stroke burden in 195 countries supersede previous GBD stroke burden findings and provide most accurate data for stroke care planning and resource allocation globally, regionally and for 195 countries. Stroke remains the second leading cause of deaths and disability worldwide. The increased stroke burden continues to exacerbate a huge pressure on people affected by stroke, their families and societies. It is imperative to develop and implement more effective primary prevention strategies to reduce stroke burden and its impact.

Short-term Effect of Stock volatility and Cardiovascular Mortality: A systematic review and meta-analysis

“…In 2017, there were 11.9 million incidences and 104.2 million prevalence. The unrealistic individual investors with high expectation could not adapt to the dramatic changes in the stock market, depression and stress would also push them to stroke (16,17). As the number of studies is small, we cannot conduct sensitivity analysis.…”

Arginine Derivatives in Cerebrovascular Diseases: Mechanisms and Clinical Implications

“…Stroke is globally the second leading cause of death and morbidity [1]. While stroke-associated mortality decreased between 1990 and 2010, stroke prevalence, incidence as well as mortality rates again raised between 2010 and 2017 [2], despite optimized treatment options and intervention programs.…”

Sleep Duration and Stroke: A Mendelian Randomization Study

“…Stroke is the second leading cause of death worldwide, with an age-standardized mortality rate of 86.5 per 100,000 population per year (1). Although stroke incidence, prevalence, mortality and disability-adjusted life-years rates have declined from 1990 to 2017, the absolute number of people who developed new stroke, died, survived or remained disabled from stroke has almost doubled (2). Globally in 2017, ischemic stroke constituted 65%, primary intracranial hemorrhage (ICH)-26% and subarachnoid hemorrhage-9% of all incidents of stroke (2).…”

“…Although stroke incidence, prevalence, mortality and disability-adjusted life-years rates have declined from 1990 to 2017, the absolute number of people who developed new stroke, died, survived or remained disabled from stroke has almost doubled (2). Globally in 2017, ischemic stroke constituted 65%, primary intracranial hemorrhage (ICH)-26% and subarachnoid hemorrhage-9% of all incidents of stroke (2). Given the global burden of stroke, it is imperative to identify other modifiable lifestyle factors to prevent stroke.…”