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September 14, 2026JACC AsiaOpen Access

Stroke Burden, Trends, and Inequalities in the Western Pacific Region, 1990-2021

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Population

Populations across 31 Western Pacific Region countries and areas from 1990 to 2021

Design

Cohort

Follow-up

31 years (1990-2021)

Key result

Population aging and growth drove an increase in absolute stroke DALYs in the Western Pacific Region from 1990 to 2021, despite age-standardized DALY rates declining to 2,326.92 per 100,000.

Authors

JGJunmiao GeMBMingdong BaoZTZhicheng Tian

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Overview

Rising absolute stroke burden from aging may require expanded care capacity; leaves open targeted prevention research in Western Pacific.

Key Points

  • To evaluate long-term trends, drivers, cross-country inequalities, and environmental risk contributions to stroke and stroke subtypes across 31 Western Pacific countries and areas between 1990 and 2021.
  • Extracted prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) for overall stroke, ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage from the Global Burden of Disease 2021 study.
  • Modeled trends using Joinpoint regression, decomposed DALY shifts into aging and demographic growth, and evaluated sociodemographic index inequalities alongside environmental-attributable fractions.
  • In 2021, the Western Pacific Region had 34.56 million prevalent stroke cases (76.00% ischemic stroke) and 64.53 million DALYs, with intracerebral hemorrhage driving 51.62% of all DALYs.
  • Age-standardized DALY rates fell from 4,155.11 (95% UI: 3,707.13-4,597.72) to 2,326.92 (95% UI: 2,011.86-2,645.09) per 100,000, yet absolute DALYs rose due to population aging (219.51%) and growth (70.27%).
  • Environmental hazards accounted for 43.78% of total stroke DALYs, led by ambient particulate matter pollution (22.22%), with lower sociodemographic index nations experiencing greater absolute health inequalities.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

P
Population
Population-level data from 31 Western Pacific Region countries and areas assessing the burden of stroke and its subtypes from 1990 to 2021.
O
Outcome
Prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) for overall stroke, ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhagehard clinical

Despite declining age-standardized DALY rates, the absolute stroke burden in the Western Pacific Region increased from 1990 to 2021, driven by population aging and growth, highlighting the need for targeted prevention strategies.

Cite This Study

Ge et al. (2026) conducted an observational in Stroke and its subtypes. Population aging, growth, and environmental exposures was evaluated on Prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) for overall stroke and subtypes. Population aging and growth drove an increase in absolute stroke DALYs in the Western Pacific Region from 1990 to 2021, despite age-standardized DALY rates declining to 2,326.92 per 100,000.

synapsesocial.com/papers/6aa7afef79e9260bc85aac7chttps://doi.org/10.1016/j.jacasi.2026.07.034
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