Disease burden and environmental risk factors of the global ischemic strokes from 1990 to 2021 and the related predictions
GE Junmiao
BAO Mingdong
GE Junli
YUE Kangyi
SUN Jidong
ZHANG Xiang
JIANG Xiaofan
LUO Peng
Abstract：Objective To analyze the disease burden and its change trend of global ischemic strokes(IS)from 1990 to 2021,and further predict the epidemiological trend up to 2050.Methods Based on the Global Burden of Disease Study 2021(GBD2021),this study assessed the incidence,mortality,and disability-adjusted life-year(DALY)associated with IS,disaggregated by sex,age,region,country,and socio-demographic index(SDI).To evaluate the change trends,estimated annual percentage change(EAPC)were calculated.The contribution of five identified environmental risk factors to DALYs due to IS was estimated.Additionally,a further prediction on the IS burden up to 2050 was made.Results From 1990 to 2021,the number of new cases,deaths and DALYs value of IS showed upward trends globally,while the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and age-standardized DALY rate(ASDR)showed downward trends,with the highest age-standardized rate(ASR)in Eastern Europe and highest cases in East Asia's China.The main risk factors for IS DALYs were ambient particulate matter pollution(APMA)and household air pollution from solid fuels(HAPSF).ARIMA model showed that the ASIR was predicted to increase from 2022 to 2050 and the ASMR and ASDR were predicted to decrease annually,while the case number of these metrics was predicted to be increasing,with predicted values of 138 million,48.05 million and 941 million in 2050 respectively.Conclusion Despite reductions in ASIR,ASMR,and ASDR,IS continues to be the leading cause of mortality and DALYs globally.The burden of IS is anticipated to escalate as a result of population growth and aging.IS is an important global public health problem,and APMA and HAPSF are important environmental factors contributing to DALY in IS patients.Substantial variation exists in ASRs across regions and countries,requiring screening in some high-risk areas,and strengthening targeted primary prevention efforts.
Keywords：ischemic strokeglobal burden of diseasedisease burdenattributable riskprediction
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：9( 6-14 )