Key result
From 1990 to 2021, the global age-standardized mortality rate for ischemic stroke attributable to high LDL-C decreased with an annual average percent change of -1.80, despite a 43.04% increase in absolute deaths.
Why the study?
Low-density lipoprotein cholesterol is linked to ischemic stroke, but long-term epidemiological characteristics of stroke burden attributable to high LDL-C needed evaluation.
Observational
While the age-standardized mortality and DALY rates for ischemic stroke attributable to high LDL-C have decreased globally from 1990 to 2021, the absolute number of deaths and DALYs has increased, highlighting the ongoing need for targeted lipid-lowering interventions, especially in middle-to-high SDI regions and aging populations.
Rising absolute ischemic stroke deaths from high LDL-C despite falling rates may support prevention focus in aging populations; leaves open causal effects of lipid-lowering.
Background: Low-density lipoprotein cholesterol (LDL-C) is a public health concern linked to ischemic stroke. The study aimed to describe the epidemiological characteristics of ischemic stroke attributable to high LDL-C from 1990 to 2021. Methods: In this study, we analyzed data from the Global Burden of Disease 2021 to present trends in ischemic stroke related to high LDL-C over the past 30 years. The relationship between disease burden and the Socio-Demographic Index (SDI) was examined. To assess international health disparities, we applied the Slope Index of Inequality (SII) and the Concentration Index (CI). Furthermore, we conducted a frontier analysis to identify areas for improvement and developmental gaps among nations, and employed the Bayesian Age-Period-Cohort (BAPC) model to forecast the disease burden for the next 15 years. Results: In 2021, the incidence of ischemic stroke attributed to high LDL-C significantly increased compared to 1990, with a more pronounced growth rate in males. The burden mainly affects individuals aged 70 to 84. Analysis using the age-period-cohort model indicates that mortality rates and DALYs rise with age, while period and cohort effects exhibit a gradual decline. Across different SDI regions, trends generally follow a similar downward path, with a narrowing gap in disease burden among regions with varying SDI levels. However, the disease burden in high SDI countries remains significant, indicating potential for reduction. Predictions for the next 15 years suggest that while the global disease burden will decrease, there may be an increase among individuals under 55. Conclusion: Compared to 1990, the overall age-standardized burden of ischemic stroke related to high LDL-C has been controlled. However, disparities persist across different SDI regions. We have observed an increasing burden among younger populations. Consequently, countries and regions must adopt new measures tailored to their SDI levels, with a specific emphasis on younger individuals. It is essential to develop prevention and treatment strategies aimed at high-risk groups.
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Tang et al. (2025) conducted an observational in Ischemic stroke attributable to high LDL-C. High LDL-C vs. 1990 baseline was evaluated on Age-standardized mortality rate (ASMR) trend (AAPC -1.80, 95% CI -2.00 to -1.60). From 1990 to 2021, the global age-standardized mortality rate for ischemic stroke attributable to high LDL-C decreased with an annual average percent change of -1.80, despite a 43.04% increase in absolute deaths.
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