Stroke Mortality Risk Factors: Global Trends and Regional Variations (1990-2021)

Stroke is a major global health challenge, affected by many risk factors. This study aimed to analyze the risk factors for death induced by 3 primary stroke subtypes from 1990 to 2021 by using data from the Global Burden of Disease 2021 database.

We examine the risk factors for death induced by 3 stroke subtypes: ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. The sociodemographic index (SDI) measures the impact of socioeconomic development on disease burden. Age-standardized death rates and estimated annual percentage changes were calculated to analyze trends.

In 2021, the global mortality rates of ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were substantial, with age-standardized death rates of 44.18, 39.09, and 4.18 per 100 000 people, respectively. The risk factors for stroke-induced death varied on the basis of region, age, and sex, with stronger impacts observed in low-SDI regions, among older individuals, and among men. Although most of the observed risk factors are decreasing globally, this trend is more pronounced in high-SDI regions. Notably, household air pollution from solid fuels remains a significant issue in low-SDI regions. High systolic blood pressure is the strongest risk factor for all stroke types, with the burden increasing rapidly among older adults. High body mass index and ambient particulate matter pollution are exhibiting increasing age-standardized death rates, particularly in middle- and low-SDI regions.

In the future, preventive measures against stroke-induced mortality should focus on low-SDI regions, older individuals, and men. Controlling high blood pressure and improving the environment will greatly reduce the burden of stroke.