TOPLINE:

The absolute stroke burden in the US rose dramatically from 1990 to 2021, with more than 400,000 new cases and 6.3 million prevalent cases in 2021 alone, new research showed. The increasing stroke prevalence was particularly high in younger populations and in regional hotspots such as Alaska, Nevada, and Arkansas.

METHODOLOGY:

• Data from 1990 to 2021 on ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in the US were obtained from the Global Burden of Disease study.
• Cases of stroke were identified using criteria from the World Health Organization and the International Classification of Diseases (ICD), 9th and 10th Revisions.
• Researchers evaluated the incidence and prevalence of stroke, as well as mortality, disability-adjusted life years (DALYs) lost, years of life lost, and years lived with disability owing to stroke.

TAKEAWAY:

• In 2021, the US recorded 0.41 million incident stroke cases (76% ischemic stroke) and 6.3 million prevalent stroke cases (5.1 million, 0.75 million, and 0.45 million involving ischemic stroke, ICH, and SAH, respectively). There were also 0.2 million stroke-related deaths and a loss of 3.9 million DALYs.
• From 1990 to 2021, the crude prevalence increased by 66% for ischemic stroke, 78% for ICH, and 71% for SAH, and incident cases increased by 10%, 28%, and 50%, respectively.
• Individuals aged 15-49 years had a 3% increase in the prevalence of stroke, and Alaska, Nevada, and Arkansas reported the greatest state-level increases in prevalence.
• However, age-standardized rates for stroke incidence were reduced by 33%, mortality by 31%, and DALYs lost by 28%, with larger declines in each of these measures for ischemic stroke than for hemorrhagic stroke subtypes.

IN PRACTICE:

“Future public health strategies must prioritize tailored age- and region-specific interventions to address modifiable risk factors, improve healthcare access, and enhance stroke awareness,” the investigators wrote.

“Continuous surveillance, robust risk factor control, and targeted healthcare interventions are essential to mitigate existing disparities and effectively manage the growing stroke burden in the US,” they added.

SOURCE:

The study was led by Jung-Hyun Park, Ewha Womans University College of Medicine, Seoul, Republic of Korea. It was published online on August 14 in the Frontiers in Neurology.

LIMITATIONS:

The study relied on administrative databases and ICD coding, leading to potential misclassification and underreporting of stroke events. The numbers of cases assigned using verbal autopsy and stroke-related deaths were not disclosed. Additionally, the analysis did not distinguish between stroke severity and recurrence, limiting the evaluation of long-term functional outcomes. Race and ethnicity data were also not included.

DISCLOSURES:

The study was funded by the Institute of Information & Communications Technology Planning & Evaluation, the Korean government, and the Korea Health Industry Development Institute. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.