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Surge in Global Stroke Rates
Context:
- A recent study published in the journal Lancet Neurology has revealed a significant rise in global stroke rates, with India experiencing a staggering 51% increase in stroke cases over the past three decades.
- This alarming trend highlights the growing public health challenge posed by strokes, particularly in low- and middle-income countries (LMICs).
A stroke, often referred to as a brain attack, happens when the blood supply to the brain is blocked or when a blood vessel bursts, leading to brain damage or death. There are two main types of strokes: Ischemic Stroke And Hemorrhagic Stroke.
Key Highlights:
- In 2021, India recorded over 1.25 million new stroke cases, a sharp rise from 650,000 cases in 1990. The prevalence of stroke in the country has also surged by 47%, from 4.4 million in 1990 to 9.4 million in 2021.
- This increase places India among the countries with the highest stroke burdens globally, accounting for 10% of the global stroke cases in 2021.
- Globally, the number of people affected by strokes rose to 11.9 million in 2021, marking a 70% increase since 1990.
- The study underscores that more than 75% of stroke victims live in LMICs, where environmental risk factors such as air pollution contribute significantly to the stroke burden.
- In these countries, the absolute number of stroke cases linked to air pollution was 20.5 million, compared to 1.46 million in high-income countries.
Contributing Factors:
- The study attributes the rising stroke rates to several factors, including population growth, an ageing population, and increased exposure to environmental and behavioural risk factors.
- Jeff Goodell’s book The Heat Will Kill You First also cites climate change and rising temperatures as reasons.
- Air pollution, in particular, has been identified as a major contributor to the increased stroke incidence in LMICs.
- Previous research has indicated that air pollution can cause inflammation and oxidative stress, raising the risk of strokes.
Global Trends in Stroke-Related Deaths and DALYs:
- The study analysed data on stroke incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 204 countries between 1990 and 2021, looking at different stroke types.
- While global stroke deaths decreased by 44%, DALYs due to stroke increased by 32%. Researchers identified six risk factor clusters, including air pollution, tobacco use, dietary habits, behavioural risks, and metabolic issues.
- Current prevention strategies are deemed insufficient, necessitating the adoption of new evidence-based methods at both population and individual levels.
Implications:
- Addressing obesity and metabolic issues is essential, particularly with rising risks associated with high blood sugar and sugary diets.
- The research highlighted the role of particulate matter air pollution in contributing to subarachnoid haemorrhage, indicating it has effects comparable to smoking.
- The study emphasises the need for enhanced surveillance, prevention measures, acute care, and rehabilitation to combat the growing stroke crisis.
