This very large epidemiological study calculated stroke incidence, prevalence, mortality, disability-adjusted life-years and the population attributable fraction of disability-adjusted life years associated with 19 risk factors, for 204 countries from 1990 to 2019. The authors found that in 2019 stroke was the second-leading cause of death, and that the absolute number of stroke cases increased significantly from 1990 to 2019. The presented data show that the bulk of the global stroke burden is in lower- and lower-middle-income countries, and suggest that the large increase in the global burden of stroke results from the combination of population growth and ageing with the substantial increase in exposure to several risk factors such as high body mass index, particulate matter pollution, high fasting plasma glucose, high systolic blood pressure, alcohol consumption, low physical activity and high temperature.
Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. GBD 2019 Stroke Collaborators. Lancet Neurol 2021 Oct;20(10):795-820 doi: 10.1016/S1474-4422(21)00252-0.