Global Stroke Burden from Metabolic Risks Across Demographics: Findings from the 2021 Global Burden of Disease Study

Abstract Background Stroke is the second leading cause of death and the primary cause of disability worldwide. Metabolic risks are major contributors to stroke. The global trends in metabolic risk-related stroke from 1990 to 2019, and the differences in mortality and DALYs across various demographic factors, remain unclear. Methods All analyses were based on rates derived from the GBD2021 results ( https://vizhub.healthdata.org/gbd-results/ ). Data were stratified by gender, region, and age. Joinpoint software was used to perform regression analysis of the average annual percent change (AAPC) and its 95% confidence interval to analyze trends from 1990 to 2019. Excel, PowerPoint, and R software were used for plotting and analysis, with p<0.05 considered statistically significant. Results From 1990 to 2019, the average annual percent change (AAPC) for age-standardized rates (ASR) of DALYs was -1.70% (−1.81%, -1.58%), and for mortality, the AAPC was -1.57% (−1.68%, -1.46%). As the SDI increased, both the ASR of DALYs and mortality in 2019 showed a significant decline. The AAPC from 1990 to 2019 also exhibited a downward trend with increasing SDI levels. The DALYs and mortality rates of metabolic risk-related stroke predominantly affected individuals aged 75 and above, with a lesser impact on those under 55. For both genders, the 10-55 and 50-74 age groups had the highest DALYs and mortality rates due to metabolic-related intracerebral hemorrhage. For those aged 75-84 and over 85, ischemic stroke was the leading subtype of metabolic-related stroke contributing to DALYs and mortality rates. Conclusion This is the first retrospective study on metabolic risk-related stroke on a global scale, summarizing its temporal trends and demographic distribution characteristics. Effective public health strategies are needed to address these disparities and continue reducing the global burden of metabolic risk-related strokes.