Worldwide, the number of stroke cases among people ages 20-64 has increased by 25% in the past two decades, according to new findings.
Traditionally associated with older populations, strokes in this age group make up 31% of the total number, compared with 25% before 1990. The overall amount of disability, illness and premature death caused by stroke is projected to more than double worldwide by 2030, according to a news release.
An international team of researchers used data and methods from Global Burden of Diseases, Injuries, and Risk Factors Study 2010 to estimate the global and regional burden of stroke from 1990-2010. Their findings were published Oct. 24 on the website of The Lancet.
This is the first study to compare incidence and impacts of stroke between countries on a global scale, first author Valery Feigin, MD, MSc, PhD, FAAN, professor and director of the National Institute for Stroke and Applied Neurosciences at Auckland University of Technology in New Zealand, said in the release. Now every country in the world has estimates of their stroke burden, based on the best available evidence. The worldwide stroke burden is growing very fast and there is now an urgent need for culturally acceptable and affordable stroke prevention, management and rehabilitation strategies to be developed and implemented worldwide.
This analysis also is described as the first time researchers have studied incidence of stroke in children and young people. Researchers found more than 83,000 people 20 and younger are affected by stroke worldwide each year 0.5% of all strokes.
The team identified 119 relevant studies published between 1990 and 2010, 58 from high-income countries and 61 from low- and middle-income countries. They used these studies to estimate the stroke incidence, prevalence, premature death and disability-adjusted life-years lost by age group in all 21 regions of the world for 1990, 2005 and 2010.
Their key findings include:
Despite the average age of stroke patients increasing slightly, most of the illness and mortality from stroke has shifted from people 75 and older to those 74 and younger. This group accounts for more than 62% of new strokes, 69.8% of total history of strokes, 45.5% of deaths and 71.7% of disability-adjusted life-years lost. These rates are greater in low- and middle-income countries, according to the release, and are rising.
In 2010, there were 16.9 million people who had a first stroke, 33 million stroke survivors, 5.9 million stroke-related deaths and 102.2 million disability-adjusted life-years lost, according to the findings. These totals showed significant increases (40%, 46%, 20% and 16%, respectively) since 1990, the authors wrote.
Although the age-standardized rates of stroke mortality have declined worldwide in the past 20 years, actual stroke-related deaths increased by 26% to 5.9 million.
In high-income countries, the age-standardized stroke rates decreased by 12%, premature death rates by 37% and disability-adjusted life-years lost by 36% since 1990. These decreases probably reflect improved education, prevention and care (such as smoking cessation, control of blood pressure, acute stroke units) and diagnosis, according to the authors.
In low-and middle-income countries, stroke mortality is 42% higher and disability-adjusted life-years lost are 46% greater than in high-income countries. The authors cite a rise in risk factors involving unhealthy diet, hypertension, obesity, physical inactivity and smoking in these countries.
Overall findings showed differences in stroke burden between world regions and national income levels, with 3-10 times as many stroke deaths and overall illness and disability between the most affected low- and middle-income countries in eastern Europe, sub-Saharan Africa, and south and east Asia compared with the least affected high-income countries in western Europe, Australasia and North America.
Study abstract: http://bit.ly/1gIRxvO