Key result
High systolic blood pressure drives ~52% rise in global stroke deaths since 1990.
Why the study?
Stroke is a leading cause of death and disability worldwide with high systolic blood pressure as a major modifiable risk factor, prompting assessment of global trends, patterns, and projections.
Observational
Yes
Effect estimate: ASMR EAPC -1.72; ASDR EAPC -1.61
Despite declining age-standardized rates, the absolute global burden of stroke attributable to high systolic blood pressure is increasing, emphasizing the need for targeted prevention in aging populations and low-SDI regions.
Provides updated global projections for HSBP-attributable stroke; leaves open optimal prevention strategies pending interventional trials.
Introduction: Stroke remains a leading cause of death and disability worldwide, with high systolic blood pressure (HSBP) being a major modifiable risk factor. This study aimed to assess global trends, age- and SDI-specific patterns, and future projections of the stroke burden attributable to HSBP among adults aged≥45 years from 1990 to 2021. Methods: Data were obtained from the Global Burden of Disease Study 2021. Mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) were analyzed across sex, age, and socio-demographic index (SDI) strata. Estimated annual percentage change (EAPC) was used to quantify temporal trends, and the ARIMA model was applied for projections to 2045. Results: In 2021, global HSBP-attributable stroke deaths and DALYs among adults aged≥45 years reached 4.12 million and 86.18 million, respectively. From 1990 to 2021, the number of deaths increased by 51.5% and DALYs by 47.9%, despite declines in ASMR (EAPC=−1.72) and ASDR (EAPC=−1.61). Mortality and DALY rates increased with age in all SDI regions, peaking at 70–79 years, with low-SDI regions showing the highest rates and an earlier peak age. High-SDI regions recorded the lowest burden and largest declines in ASMR and ASDR. Projections indicate a continued global decline in mortality rates through 2045, with a faster reduction in females. Conclusion: Although the global age-standardized burden of HSBP-attributable stroke has declined, absolute cases continue to rise, especially among older adults and in low-SDI regions, highlighting the need for targeted prevention.
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Yu et al. (2026) conducted an observational in Stroke attributable to high systolic blood pressure. High systolic blood pressure was evaluated on Stroke deaths and disability-adjusted life years (DALYs) (ASMR EAPC -1.72; ASDR EAPC -1.61). Global stroke deaths attributable to high systolic blood pressure in adults ≥45 years increased by 51.5% from 1990 to 2021, despite declines in age-standardized mortality rates (EAPC=-1.72).
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