Key result
Global age-standardized death rates for high BMI-linked ischemic stroke fall ~20% despite rising absolute numbers.
Why the study?
Ischemic stroke is a major contributor to global disease burden with overweight/obesity as a primary risk factor, but the distribution and changes in IS burden attributable to high BMI required evaluation.
What is the global burden of ischemic stroke attributable to high body-mass index from 1990 to 2021?
Observational
What is the global burden of ischemic stroke attributable to high body-mass index from 1990 to 2021?
Effect estimate: EAPC -1.10 (95% CI -0.96 to -1.25)
Absolute Event Rate: 2.06% vs 2.57%
The absolute global burden of ischemic stroke attributable to high BMI has nearly doubled from 1990 to 2021, highlighting the urgent need for targeted prevention strategies, particularly in low- and middle-income countries and among younger populations.
Declining rates suggest mitigation gains; leaves open drivers of doubled absolute burden for targeted study.
Background Ischemic stroke (IS) is a significant contributor to the global disease burden, with overweight/obesity recognized as one of the primary risk factors. This study aims to evaluate the distribution and changes in the global burden of IS attributable to high body-mass index (BMI) from 1990 to 2021, providing a foundation for the development of targeted prevention and treatment strategies. Methods Based on the modeling strategies of the 2021 global burden of disease (GBD) dataset, the burden of IS attributable to high BMI was estimated. The assessment covered the global disease burden and its distribution by region, country, development level, age group, and gender, as well as temporal trends. Age-standardized rates, along with the estimated annual percentage change (EAPC) in these rates, were utilized to describe this burden and its evolving trends. Locally estimated scatterplot smoothing (LOESS) regression was employed to analyze the trends of disease burden in relation to changes in socio-demographic index (SDI). Results From 1990 to 2021, although the age-standardized death rate and disability-adjusted life years (DALY) rate for IS attributable to high BMI have declined globally, the absolute number of deaths and DALYs nearly doubled, reaching 172,390.65 (95% UI, 347,912.75 to 25,064.57) and 4,439,186.31 (95% UI, 8,647,485.11 to 649,030.21) respectively. Meanwhile, significant disparities in disease burden existed across different regions, genders, and age groups. In high-middle SDI regions, the burden of IS caused by high BMI significantly exceeded that in other regions, while in low-income areas, this burden was rapidly increasing. Additionally, the increase in burden among men was significantly greater than that among women, and the previously concentrated burden in the elderly is now rapidly shifting toward younger groups. Conclusions The overweight and obese populations continue to present significant challenges in managing the burden of IS. In light of future population growth and aging trends, more effective stroke prevention strategies and practical solutions are urgently needed, particularly in low- and middle-income countries. Additionally, given the increasing disease burden among men and younger populations, it is essential to establish targeted preventive measures to address the specific needs of different groups and improve overall health outcomes.
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Zhang et al. (2024) conducted an observational in Ischemic stroke attributed to high body-mass index. High body-mass index vs. 1990 baseline was evaluated on Age-standardized death rate per 100,000 population (EAPC -1.10, 95% CI -0.96 to -1.25). From 1990 to 2021, the global age-standardized death rate for ischemic stroke attributable to high BMI decreased from 2.57 to 2.06 per 100,000 population, despite absolute numbers nearly doubling.
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