Zhao Haonan, Lu Sikai, Jie Yang, Chao Wu, Zhu Wenxia, Huang Dongya
Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Pudong New Area Sanlin Community Health Service Center, Shanghai, China.
Front Neurol. 2025 Mar 19;16:1492691. doi: 10.3389/fneur.2025.1492691. eCollection 2025.
Estimating the global burden of ischemic strokes (IS) is crucial for enhancing prevention and control strategies.
We collected four epidemiological indicators-prevalence, incidence, deaths, and disability-adjusted life years (DALYs)-for ischemic stroke (IS) from the Global Burden of Disease (GBD) database, which covers the years 1990 to 2021. Our research analyzed the features of the IS burden and described the trends of these four indicators.
The Joinpoint and age-period-cohort models reflected the changing trends in age-standardized indicators. Decomposition analysis examined the factors influencing each epidemiological indicator. The Bayesian Age-Period-Cohort (BAPC) model detailed changes in the number and rate of IS from 1990 to 2021 and projected trends through 2046. The Norpred model was used to verify the stability of the BAPC prediction results. The prevalence, incidence, deaths, and DALYs due to IS generally exhibited a downward trend. However, the predictions indicated that while the age-standardized incidence rate decreased from 1990 to 2015, this trend reversed between 2016 and 2021 and is expected to continue until 2046. This reversal is likely driven by factors such as population aging, given that age is a strongly correlated risk factor for IS. The IS burden was negatively associated with socio-demographic index (SDI) levels, with high systolic blood pressure identified as the largest risk factor for DALYs and deaths. The consistency between the BAPC and Norpred models enhances the reliability of these projections.
Over the past two decades, trends in prevalence, incidence, deaths, and DALYs have all declined. However, projections suggest that incidence will show an upward trend over the next two decades.
评估缺血性卒中（IS）的全球负担对于加强预防和控制策略至关重要。
我们从全球疾病负担（GBD）数据库收集了1990年至2021年期间缺血性卒中（IS）的四项流行病学指标——患病率、发病率、死亡人数和伤残调整生命年（DALYs）。我们的研究分析了IS负担的特征，并描述了这四项指标的趋势。
Joinpoint模型和年龄-时期-队列模型反映了年龄标准化指标的变化趋势。分解分析考察了影响各项流行病学指标的因素。贝叶斯年龄-时期-队列（BAPC）模型详细分析了1990年至2021年期间IS的数量和发病率变化，并预测了至2046年的趋势。使用Norpred模型验证BAPC预测结果的稳定性。IS导致的患病率、发病率、死亡人数和DALYs总体呈下降趋势。然而，预测表明，虽然年龄标准化发病率在1990年至2015年期间有所下降，但在2016年至2021年期间出现逆转，预计将持续到2046年。鉴于年龄是IS的一个强相关风险因素，这种逆转可能是由人口老龄化等因素驱动的。IS负担与社会人口指数（SDI）水平呈负相关，收缩压升高被确定为DALYs和死亡的最大风险因素。BAPC模型和Norpred模型之间的一致性提高了这些预测的可靠性。
在过去二十年中，患病率、发病率、死亡人数和DALYs的趋势均有所下降。然而，预测表明，在未来二十年中发病率将呈上升趋势。
