Global, Regional, and National Burdens of Ischemic Stroke Attributed to High Body-mass Index from 1990 to 2021

Abstract

BackgroundIschemic stroke (IS) is a significant contributor to the global disease burden, with overweight/obesity recognized as one of the primary risk factors. This study aims to evaluate the distribution and changes in the global burden of IS attributable to high body-mass index (BMI) from 1990 to 2021, providing a foundation for the development of targeted prevention and treatment strategies.MethodsBased on the modeling strategies of the 2021 global burden of disease (GBD) dataset, the burden of IS attributable to high BMI was estimated. The assessment covered the global disease burden and its distribution by region, country, development level, age group, and gender, as well as temporal trends. Age-standardized rates, along with the estimated annual percentage change (EAPC) in these rates, were utilized to describe this burden and its evolving trends. Locally estimated scatterplot smoothing (LOESS) regression was employed to analyze the trends of disease burden in relation to changes in socio-demographic index (SDI).ResultsFrom 1990 to 2021, although the age-standardized death rate and disability-adjusted life years (DALY) rate for IS attributable to high BMI have declined globally, the absolute number of deaths and DALYs nearly doubled, reaching 172,390.65 (95% UI, 347,912.75 to 25,064.57) and 4,439,186.31 (95% UI, 8,647,485.11 to 649,030.21) respectively. Meanwhile, significant disparities in disease burden existed across different regions, genders, and age groups. In high-middle SDI regions, the burden of IS caused by high BMI significantly exceeded that in other regions, while in low-income areas, this burden was rapidly increasing. Additionally, the increase in burden among men was significantly greater than that among women, and the previously concentrated burden in the elderly is now rapidly shifting toward younger groups.ConclusionsThe overweight and obese populations continue to present significant challenges in managing the burden of IS. In light of future population growth and aging trends, more effective stroke prevention strategies and practical solutions are urgently needed, particularly in low- and middle-income countries. Additionally, given the increasing disease burden among men and younger populations, it is essential to establish targeted preventive measures to address the specific needs of different groups and improve overall health outcomes.