Global, regional, and national burdens of intracerebral hemorrhage and its risk factors from 1990 to 2021

The aim of this study was to assess the intracerebral hemorrhage (ICH) burden in 204 countries and territories worldwide from 1990 to 2021, disaggregated by sex, age, and sociodemographic index (SDI) at the global, regional, and country levels. Data from the 2021 Global Burden of Disease Study (GBD) were used to calculate age-standardized prevalence (ASPR), incidence (ASIR), death (ASDR), and disability-adjusted life year (DALY) rates for ICH. The estimated annual percentage change (EAPC) was used to assess time patterns. The Bayesian age-period-cohort (BAPC) model was employed to predict future ICH burden. In 2021, the global ICH burden remained high, with a total of 16.6 million cases and an ASPR of 194.51 cases per 100,000 people. The ASIR was 40.83 cases per 100,000 people, the ASDR was 39.09 cases per 100,000 people, and the age-standardized DALY rate was 923.64 per 100,000 people. The low-SDI regions had the highest ASPR, ASIR, ASDR, and DALY rates. Geographically, western sub-Saharan Africa had the highest ASPR, Central Asia had the highest ASIR, and Oceania had the highest ASDR and DALY rates. High systolic blood pressure was the leading risk factor for ICH death, contributing to 57.9% of global fatalities. Despite the decline in the ASIR, there is an ongoing increase in the absolute number of ICH cases, with significant differences observed across age, sex, region, country, and SDI. More attention and emphasis should be placed on improving the ICH burden in low-SDI areas.