Stroke increase
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Increasing Global Stroke Incidence: A Comprehensive Analysis
Global Stroke Incidence Trends
Rising Stroke Incidence in Low-Income and Middle-Income Countries
The global burden of stroke has seen significant changes over the past few decades. From 1990 to 2010, the age-standardized incidence of stroke decreased by 12% in high-income countries but increased by 12% in low-income and middle-income countries, although this increase was not statistically significant. This trend continued into 2019, with the absolute number of incident strokes rising by 70% from 1990 to 2019. The increase in stroke incidence in low-income regions is particularly concerning, as these areas also experience higher stroke-related mortality and disability-adjusted life years (DALYs) lost .
Stroke Incidence Among Younger Populations
While overall stroke incidence rates have decreased globally, there has been a notable increase in stroke cases among younger populations. From 1990 to 2016, the incidence rates for individuals younger than 50 years increased, and prevalence rates for this group have also risen significantly since 2005. This trend is alarming as it suggests that younger individuals are becoming more susceptible to stroke, potentially due to lifestyle changes and other risk factors.
Mortality and Disability Trends
Decreasing Age-Standardized Mortality Rates
Despite the rising number of stroke cases, age-standardized mortality rates have decreased globally. From 1990 to 2010, stroke mortality rates fell by 37% in high-income countries and by 20% in low-income and middle-income countries. Similarly, from 1990 to 2019, age-standardized stroke mortality rates decreased by 36%. These reductions are attributed to better stroke prevention and management strategies, including improved control of risk factors such as hypertension and smoking .
Increasing Absolute Numbers of Stroke-Related Deaths and DALYs
However, the absolute numbers of stroke-related deaths and DALYs have increased. In 2019, there were 6.55 million deaths from stroke, a 43% increase from 1990. The total DALYs due to stroke also rose by 32% during the same period. This increase in absolute numbers highlights the growing global burden of stroke, despite improvements in age-standardized rates.
Risk Factors and Prevention
Major Risk Factors for Stroke
High systolic blood pressure, high body-mass index, high fasting plasma glucose, ambient particulate matter pollution, and smoking are the leading risk factors for stroke. High blood pressure alone contributes to 54% of stroke episodes worldwide. Effective management of these risk factors is crucial for reducing the global stroke burden.
Importance of Rehabilitation and Physical Activity
Rehabilitation plays a vital role in improving outcomes for stroke survivors. Increasing the amount of usual rehabilitation significantly improves activity levels in stroke patients. High-intensity walking and step activity interventions have also been shown to increase physical activity, which is essential for reducing recurrent stroke risk and improving daily function .
Conclusion
The global burden of stroke is increasing, particularly in low-income and middle-income countries and among younger populations. While age-standardized mortality rates have decreased, the absolute numbers of stroke cases, deaths, and DALYs continue to rise. Addressing major risk factors and enhancing rehabilitation efforts are critical steps in mitigating the impact of stroke worldwide. Urgent implementation of effective primary prevention strategies is necessary to curb the growing stroke burden, especially in vulnerable regions.
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