Stroke facts
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Global Stroke Facts and Insights
Stroke as a Leading Cause of Death and Disability
Global Mortality and Disability Rates
Stroke is the second leading cause of death globally and a major contributor to disability. It accounts for a significant number of deaths and disability-adjusted life years (DALYs) lost worldwide . The annual mortality rate from stroke is approximately 5.5 million, with up to 50% of survivors experiencing chronic disability.
Economic Impact
The global economic burden of stroke is substantial, with estimated costs exceeding US$721 billion, which is about 0.66% of the global GDP. This financial strain is felt more acutely in lower-income and lower-middle-income countries (LMICs), where 86% of stroke deaths and 89% of DALYs occur.
Epidemiological Trends
Increasing Incidence in Developing Countries
While developed regions have seen a decrease in stroke incidence due to better prevention and control of risk factors, developing countries are experiencing an increase. This rise is attributed to aging populations and poor dietary behaviors. From 1990 to 2019, there was a 70% increase in incident strokes and a 102% increase in prevalent strokes globally.
Age and Gender Disparities
The incidence of stroke is higher in males than females, particularly in aging populations. However, due to longer life expectancy, females have a higher overall incidence of stroke, especially after menopause due to estrogen deficiency. Younger age groups (under 50 years) have also seen an increase in stroke prevalence since 2005.
Types and Causes of Stroke
Ischemic vs. Hemorrhagic Stroke
Approximately 85% of strokes are ischemic, caused by blockages in blood vessels, while 15% are hemorrhagic, resulting from bleeding in the brain . Ischemic strokes are often due to small vessel arteriolosclerosis, cardioembolism, and large artery athero-thromboembolism. Hemorrhagic strokes can be deep (due to hypertensive arteriopathy) or lobar (often caused by cerebral amyloid angiopathy).
Risk Factors
Hypertension is the most significant modifiable risk factor for stroke. Other risk factors include smoking, poor diet, physical inactivity, and conditions like diabetes and atrial fibrillation . Recent studies also highlight the role of genetic factors and environmental interactions in stroke risk.
Prevention and Management
Prevention Strategies
Effective stroke prevention focuses on managing modifiable risk factors through lifestyle changes such as dietary improvements and smoking cessation. Medical management of conditions like hypertension and diabetes is also crucial. Tools like the Stroke Riskometer app, supported by the World Stroke Organization (WSO), help in raising awareness and educating the public about stroke risks.
Treatment and Rehabilitation
Stroke treatment aims to restore blood flow to the brain and manage neurological damage. Advances in stroke research have led to better understanding and identification of therapeutic targets, although challenges remain in clinical trial success. Post-stroke care significantly impacts families, healthcare systems, and economies, emphasizing the need for improved pre-clinical and clinical care.
Conclusion
Stroke remains a critical public health issue with significant mortality, disability, and economic impacts worldwide. While progress has been made in understanding and managing stroke, the burden continues to rise, particularly in developing countries. Effective prevention, timely treatment, and comprehensive rehabilitation are essential to mitigate the long-term effects of stroke and improve outcomes for survivors.
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