Global Burden, Risk Factors Analysis, and Prediction Study of Ischemic Stroke, 1990-2030.

PURPOSE Ischemic stroke (IS), one of the two main subtypes of stroke, occurs due to brain ischemia as a result of thrombosis of a cerebral blood vessel. IS is one of the most important neurovascular causes of death and disability. It is affected by many risk factors, such as smoking and high body mass index (BMI), which are also critical in the preventive control of other cardiovascular and cerebrovascular diseases. However, there are still few systematic analyses of the current and predicted disease burden, as well as the attributable risk factors for ischemic stroke. METHODS Based on the GBD2019 database, we used age-standardized mortality rate (ASMR) and disability-adjusted life year (ASDR) to systematically present the geographical distribution and trends of ischemic stroke disease burden worldwide from 1990 to 2019 by calculating the estimated annual percentage change (EAPC), and to analyze and predict the death number of IS accounted by seven major risk factors for 2020-2030. RESULTS Between 1990 and 2019, the global number of IS deaths increased from 2.04 million to 3.29 million and is expected to increase further to 4.90 million by 2030. The downward trend was more pronounced in women, young people, and high social-demographic index (SDI) regions. At the same time, a study of attributable risk factors for IS found that two behavioral factors, smoking and diet in high sodium, and five metabolic factors, including high systolic blood pressure, high low-density lipoprotein cholesterol, kidney dysfunction, high fast plasma glucose, and high BMI, are major contributors to the increased disease burden of IS now and in the future. CONCLUSIONS Our study provides the first comprehensive summary for the last thirty years and the prediction of the global burden of IS and its attributable risk factors until 2030, providing detailed statistics for decision-making on the prevention and control of IS globally. Inadequate control of the seven risk factors would lead to an increased disease burden of IS in young people, especially in low SDI regions. Our study identifies high-risk populations and helps public health professionals develop targeted preventive strategies to reduce the global disease burden of ischemic stroke.