What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic stroke. Primary outcome: Age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs).

What does this research mean for the field?

Between 1990 and 2021, ischemic stroke incident cases increased by 161.79% in the Western Pacific region, while age-standardized mortality declined by 58.45% in the European region, demonstrating wide regional disparities in global stroke burden. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research aims to analyze the burden of ischemic stroke across WHO regions and identify disparities over time.

May 20, 2026Open Access

Ischemic stroke burden across the World Health Organization regions: Temporal dynamics, regional inequalities, and forecasting insights from the Global Burden of Disease 2021 data

Key Result

Analysis of GBD 2021 data showed ischemic stroke incident cases increased by 161.79% in the Western Pacific region, while age-standardized mortality declined by 58.45% in the European region.

Key Points

The research aims to analyze the burden of ischemic stroke across WHO regions and identify disparities over time.
Utilized 2021 Global Burden of Disease data to evaluate stroke burden from 1990 to 2021.
Assessed age-standardized incidence, prevalence, mortality, and disability-adjusted life years.
Applied joinpoint regression for trend analysis and predictive modeling using ARIMA.
Western Pacific region saw a 161.79% increase in incident cases (95% UI: 145.49–155.68).
Southeast Asia region experienced a 137.33% rise in DALYs (95% UI: 111.78–165.59).
European region demonstrated a decline in age-standardized mortality by -58.45% (95% UI: -60.13 to -56.79).

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

Population

Global population across World Health Organization (WHO) regions from 1990 to 2021, using Global Burden of Disease (GBD) 2021 data

Outcome

Age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of ischemic strokehard clinical

Ischemic stroke burden varies significantly across WHO regions, with rising incidence and prevalence projected globally by 2036 despite declining mortality.

Abstract

Abstract: BACKGROUND: Ischemic stroke remains a leading cause of death and disability worldwide, with significant differences across the World Health Organization (WHO) regions. Understanding these disparities is crucial for targeted public health strategies. MATERIALS AND METHODS: Using data from the 2021 Global Burden of Disease (GBD) study, we analyzed ischemic stroke burden across the WHO regions from 1990 to 2021. Age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were assessed. Trends were assessed through joinpoint regression, with a maximum of five joinpoints. Future projections were generated using Autoregressive Integrated Moving Average ( P = 3, d = 1, and q = 1) model. RESULTS: In 2021, a significant variation in the burden of ischemic stroke was evident across different WHO regions. The Western Pacific region saw the most pronounced growth in total incident cases, with an increase of 161.79% (95% UI: 145.49–155.68). Meanwhile, the Southeast Asia region experienced the greatest escalation in DALYs, rising by 137.33% (95% UI: 111.78–165.59). The European region showed the greatest decline in age-standardized mortality (−58.45%, 95% UI: −60.13 to −56.79) and DALYs (−54.50%, 95% UI: −56.52 to −52.67). Gender disparities were evident, particularly in the African region, where females bore a disproportionately higher burden. Predictive modeling suggests a continued decline in stroke mortality and DALYs, but a rising incidence and prevalence in all regions by 2036. CONCLUSIONS: The ischemic stroke burden varies widely across the WHO regions due to factors like aging populations, shifting disease patterns, and healthcare capacity. These findings underscore the need for region-specific prevention and management strategies to reduce the global stroke burden.