Differences in the burden and temporal trend of stroke in the Belt and Road Initiative countries, 1990-2021.

OBJECTIVES

To analyze the differences in the burden and trend of disability caused by stroke in "Belt and Road" ("B&R") countries from 1990 to 2021.

METHODS

We applied GBD 2021 to compare stroke incidence, mortality, the years lived with disability (YLDs) and disability-adjusted life-years (DALYs) from 1990 to 2021 in the "B&R" countries. The average annual percent change (AAPC) was used to analyze the temporal trends of age-standardized YLDs rate of stroke from 1990 to 2021 by Joinpoint regression analysis.

RESULTS

China, India and Indonesia had the highest absolute stroke numbers of stroke. From 1990 to 2021, the AAPC values of age-standardized metrics showed a downward trend in most of "B&R" countries. Turkmenistan had the highest increase in AAPCs of age-standardized YLDs rate for men (AAPC=0.60 %), while for women Philippines had the highest increase (AAPC=0.57 %). For under 15 years, YLDs due to stroke in most member states showed a downward trend, while increasing trends were noted in Saudi Arabia and Turkmenistan. Globally, metabolic, environmental/occupational and behavioral risk factors showed significant reductions (AAPC: -0.12 %, -0.92 %, and -0.53 %, respectively).

CONCLUSIONS

The overall burden of stroke remains enormous, with regional, age and gender disparities. Enhanced health cooperation among B&R countries is warranted.