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Abstract
Background and Objectives To estimate the rates of incidence, death, and disability-adjusted life years (DALYs) of ischemic stroke in young adults aged 15–49 years and the relevant risk factors by sex, age group, and sociodemographic index (SDI) in 204 countries and territories.
Methods Data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2019 study were used. The estimated annual percentage changes (EAPCs) were calculated to evaluate the temporal trends from 1990 to 2019. We also estimated the risk factors contributing to DALYs resulting from ischemic stroke.
Results From 1990 to 2019, the global age-standardized incidence (EAPC = −0.97), death (EAPC = −0.11), and DALYs rates (EAPC = −0.55) of ischemic stroke in young adults decreased. The largest increases in age-standardized incidence, death, and DALYs rates were observed in the low and low-middle SDI quintiles. At the regional level, North Africa and the Middle East and Southeast Asia showed the largest increases in the age-standardized incidence, death, and DALYs rates of ischemic stroke. The age-standardized incidence rate was higher among young women than among young men in 2019. Globally, a high environmental temperature, high body mass index (BMI), and a high fasting plasma glucose contributed to the largest increases in age-standardized DALYs rates between 1990 and 2019. In the same period, the largest increases in the age-standardized DALYs rates in high-SDI and low-SDI regions were attributable to high environmental temperatures and alcohol use, respectively.
Discussion The burden of ischemic stroke in young adults continues to increase in low-SDI regions such as North Africa and the Middle East and Southeast Asia. There were differences in the primary risk factors related to the burden of ischemic stroke in different SDI regions. Targeted implementation of cost-effective policies and interventions is an urgent need to reduce the burden of ischemic stroke in young adults.
Glossary
- BMI=
- body mass index;
- CI=
- confidence interval;
- CODEm=
- Cause of Death Ensemble modeling;
- DALYs=
- disability-adjusted life years;
- ICD=
- International Classification of Diseases;
- EAPCs=
- estimated annual percentage changes;
- GBD=
- Global Burden of Disease;
- GHDx=
- Global Health Data Exchange;
- LDL=
- low-density lipoprotein;
- LMIC=
- low- and middle-income country;
- SDI=
- sociodemographic index;
- TMREL=
- theoretical minimum risk exposure level;
- UIs=
- uncertainty intervals;
- VA=
- verbal autopsy;
- VR=
- vital registration;
- WHO=
- World Health Organization
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was José Merino, MD, MPhil, FAAN.
CME Course: NPub.org/cmelist
- Received April 20, 2022.
- Accepted in final form September 9, 2022.
- © 2022 American Academy of Neurology
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