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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1492691
Comprehensive Analysis of Global, Regional, and National Ischemic Stroke Burden (1990-2021): Trends, Influencing Factors, and Future Projections
Provisionally accepted- 1 Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- 2 Pudong New Area Sanlin Community Health Service Center, Shanghai, China
Background and Purpose: Projecting the global burden of ischemic strokes (IS) is essential for optimizing prevention and control strategies. Methods: We collected 4 epidemiological indicators: prevalence, incidence, death, and disability-adjusted life years (DALYs) in (IS) from the Global Burden of Disease (GBD) database from 1990 to 2021. Our research analyzed the feature of IS burden, described the trend of 4 epidemiological indicators. Results: The Joinpoint and age-period-cohort models reflected the change trends of age-standardized indicators. Decomposition analysis was used to examine the factors influencing each epidemiological indicator. The Bayesian Age-Period-Cohort (BAPC) model described the changes in the number and rate of ischemic stroke (IS) from 1990 to 2021 and projected trends to 2046. The Norpred model was used to verify the stability of the BAPC prediction results. The prevalence, incidence, death, and DALYs due to IS generally exhibited a downward trend. However, the prediction results showed that while the age-standardized incidence rate decreased from 1990 to 2015, this trend reversed between 2016 and 2021 and is projected to persist until 2046.This reversal is likely driven by factors such as population aging, as age is a highly correlated risk factor for IS. The IS burden was negatively related to socio-demographic index (SDI) levels, with high systolic blood pressure identified as the largest risk factor for DALYs and death. The consistency between the BAPC and Norpred models enhances the reliability of these projections.Conclusions:Over the past two decades, the trends in prevalence, incidence, death, and DALYs have decreased. However, projections indicate that incidence will show an increasing trend in the next two decades.
Keywords: Global Burden of Disease study, ischemic stroke, Joinpoint regression, Trends analysis, Preventive Health Services, Forecasting analysis
Received: 07 Sep 2024; Accepted: 28 Feb 2025.
Copyright: © 2025 Zhao, Lu, Jie, Chao, Zhu and Dongya. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haonan Zhao, Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
Huang Dongya, Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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