Global Deaths from Ischemic Stroke May Reach 5 Million by 2030, According to New Study

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Between 1990 and 2019, the global number of deaths from ischemic stroke (IS) increased from approximately 2 million to 3 million and is expected to increase further to almost 5 million by 2030, according to a new study.

Researchers also identified 7 risk factors—2 behavioral and 5 metabolic—that are “major contributors” to the increased disease burden of IS.

Findings were published online May 17, 2023, in Neurology.

“This increase in the global death toll of ischemic stroke along with a predicted further increase in the future is concerning, but ischemic stroke is highly preventable,” said study coauthor Lize Xiong, MD, of Tongji University in Shanghai, China, in an AAN press release. “Our results suggest that a combination of lifestyle factors like smoking and a diet high in sodium along with other factors such as high blood pressure and high body mass index can lead to an increased risk of stroke.”

Xiong and colleagues conducted the current study to further understand the current and predicted global disease burden of IS including identification of populations at high risk as well as attributable risk factors. They analyzed data from the Global Health Data Exchange from 1990 to 2019, and specifically looked at mortality and disability-adjusted life years of IS among different ages, genders, and risk factors in 204 countries and territories.

Investigators found that as population grew, the global number of IS deaths increased from 2.04 million in 1990 to 3.29 million in 2019. The stroke rate, however, decreased from 66 strokes per 100 000 persons in 1990 to 44 strokes per 100 000 persons in 2019.

“This decrease in the stroke rate likely means that the overall increase in the number of strokes worldwide is mainly due to population growth and aging,” said Xiong in the release.

The research team identified the following 7 risk factors for IS:

• Smoking
• A diet high in sodium
• High systolic blood pressure
• Increased low-density lipoprotein cholesterol
• Kidney dysfunction
• High fasting blood sugar levels
• Having a high body mass index

In addition, investigators used the data from the Global Health Data Exchange to predict the number of IS deaths for 2020-2030. They observed that the global number of IS deaths is expected to increase further to 4.90 million by 2030. When authors factored in the 7 risk factors, they estimated that the overall number of IS deaths could reach 6.4 million if the risk factors are not controlled or prevented.

“Our findings have implications for the allocation of care resources, health care planning, and the development and implementation of primary prevention interventions for stroke that require support from data, primarily including the reduction of metabolic risk factors (eg, blood glucose and weight screening and management) and behavioral risk factors (eg, smoking cessation and improving poor dietary habits),” concluded Xiong et al.

“In addition, at the national level, the reduction of poverty and racial and socio-economic inequalities through appropriate measures, such as legislation and taxation, will be important to reduce cardiovascular disease, as well as other non-communicable diseases,” they wrote.

A limitation of the study was that the quality and accuracy of disease data from some countries cannot be guaranteed as many did not have reliable information on IS.

Reference: Xiong L, Fan J, Li X, et al. Global burden, risk factors analysis, and prediction study of ischemic stroke, 1990-2030. Neurology. Published online May 17, 2023. Doi:10.1212/WNL.0000000000207387.