Global Stroke Deaths Still a Concern, and It's Not Just About Developing Countries

 With some actual stroke leadership deaths could be vastly reduced by just stopping the 5 causes of the neuronal cascade of death in the first week saving hundreds of million to billions of neurons! AND YOU DON'T KNOW THAT? My God, the complete incompetence out there and these are stroke researchers and the AHA/ASA!)

Global Stroke Deaths Still a Concern, and It's Not Just About Developing Countries

      Researchers urge expanded hypertension screening, environmental policies

by Nicole Lou, Senior Staff Writer, MedPage Today June 6, 2025 • 3 min read

Key Takeaways

• This analysis counted over 93.8 million strokes worldwide in 2021, with over 7.25 million related deaths.
• Blood pressure control and environmental policy improvements were projected to reduce the burden of stroke.
• Researchers urged preventive measures that focus on poorer areas, older individuals, and men.

Though stroke mortality has decreased over the last few decades, there is still room for improvement, researchers said.

Using global data on stroke mortality and risk factors as recent as 2021, age-standardized death rates were estimated for three major stroke subtypes:

• Ischemic stroke (IS): 44.18 per 100,000 people
• Intracerebral hemorrhage (ICH): 39.09 per 100,000 people
• Subarachnoid hemorrhage (SAH): 4.18 per 100,000 people

While high systolic blood pressure remained a key driver of IS, ICH, and SAH deaths across the board, there were specific regional and sociodemographic challenges, reported Fuyou Guo, MD, of the First Affiliated Hospital of Zhengzhou University in China, and colleagues in the Journal of the American Heart Association.

"Stroke is a leading global cause of death and disability, and it imposes a significant burden on healthcare systems and society," they noted in their introduction.

"High-SDI [sociodemographic index] regions have made progress, but low- and middle-SDI areas face challenges like air pollution and obesity," they wrote. "Risk factors differ by region, age, and sex, with household air pollution in low-SDI areas, worsening pollution in middle-SDI regions, earlier risks for ICH and SAH in older populations, and higher smoking and alcohol use among men."

Based on their results, the authors came up with several key policy recommendations:

• Strengthen hypertension management through expanded blood pressure screening and treatment programs (particularly in middle- and low-SDI regions)
• Promote clean energy solutions by increasing access to affordable alternatives to solid fuels via government subsidies and international aid programs (particularly in low-SDI areas)
• Implement stricter industrial and vehicular emission controls to reduce ambient particulate matter (particularly for middle-SDI regions)
• Improve nutrition policies, such as introducing regulations on sugar and fat content, promoting healthy eating habits, and enhancing food-labeling practices
• Strengthen tobacco and alcohol control through higher taxation, advertising restrictions, and public awareness campaigns

"In sum, controlling high systolic blood pressure, managing blood sugar and lipid levels, and addressing environmental factors such as air pollution and household air pollution from solid fuels remain critical to stroke prevention," Guo and colleagues emphasized. "Tailored strategies that consider the unique challenges of each region will be key in reducing the stroke burden globally."

In 2021, the number of people affected by stroke worldwide exceeded 93.8 million, with over 7.25 million related deaths. Broken down by stroke subtype, this amounted to 3.5 million IS deaths, over 3.3 million ICH deaths, and over 350,000 SAH deaths.

National estimates for the U.S. suggest a continued drop in age-adjusted death rates from stroke (from 41.1 per 100,000 in 2021 to 39.5 per 100,000 in 2022). However, the actual number of stroke deaths increased by 28.7%.

Here, the prevalence of stroke itself has remained largely stable in recent decades.

For this study, the authors used the Global Burden of Disease database of health outcomes, with the SDI as a measure of socioeconomic development in various nations and regions.

Of note, the database did not capture genetic data or important clinical factors such as lesion size, stroke severity, related complications, and local access to healthcare.

"Addressing these limitations in future research could lead to a deeper understanding of the epidemiological characteristics of stroke and provide a basis for developing more targeted prevention strategies," Guo and team wrote.

• 

  Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded by grants from the National Key Research and Development Program of China and the National Natural Science Foundation of China.

Guo and colleagues had no disclosures.

Primary Source

Journal of the American Heart Association

Source Reference: Song D, et al "Stroke mortality risk factors: global trends and regional variations (1990-2021)" J Am Heart Assoc 2025; DOI: 10.1161/JAHA.125.042107.