And just what the fuck is stroke leadership doing to solve this problem? I'm sure ABSOLUTELY NOTHING but clutching their pearls and exclaiming how bad stroke is! Doing nothing is the stock in trade in stroke. Who the fuck cares about survivors not recovering?
Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Summary
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.(So doing nothing once you have the stroke. Good to know you don't give a shit about survivors.)
Funding
Bill & Melinda Gates Foundation.
Introduction
Disease
and population distribution patterns, life expectancy, mortality,
causes of death, and socio-demographic factors continue to change across
the world, including ageing of populations and changes in the
prevalence of risk factors for non-communicable disorders. Timely
estimates of the burden of stroke and its pathological types, the burden
attributable to risk factors, and trends in the burden over time are
necessary at the global, regional, and national levels to guide
evidence-based health-care policy, planning, and resource allocation for
stroke.
More blathering at the link.
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