In a study published in the Lancet Neurology journal, it is projected that the global number of stroke-related deaths will increase by 50% by the year 2050, reaching a staggering 9.7 million deaths per year. Additionally, the economic costs associated with stroke are estimated to rise as high as USD 2.3 trillion annually if no immediate action is taken. These findings underscore the urgent need for intervention.
The analysis reveals that the health and economic impacts of stroke are expected to grow significantly between 2020 and 2050, with a disproportionate burden falling on lower and middle-income countries (LMICs). The prevalence of stroke in LMICs is increasing at a faster rate than in High-Income Countries (HICs).
To address this alarming trend, the study draws on evidence-based guidelines, recent surveys, and in-depth interviews with stroke experts from around the world to propose pragmatic recommendations. These recommendations focus on enhancing stroke surveillance, prevention, acute care, and rehabilitation.
Over the past 30 years, the number of people globally affected by stroke, including those who suffer a stroke, die from it, or remain disabled, has nearly doubled. LMICs bear the brunt of this increase. If current trends persist, there is a risk that one of the World Health Organization’s key Sustainable Development Goals (SDG 3.4) will not be met. This goal aims to reduce premature deaths from non-communicable diseases, such as stroke, by one-third by 2030. While achieving this goal would require an investment of USD 140 billion between 2023 and 2030, the benefits would far outweigh the costs.
Professor Valery L. Feigin, co-chair of the commission behind this study, emphasizes the massive toll that stroke exacts on the global population. It results in millions of deaths and permanent disabilities annually, while costing billions of dollars.
“Precisely forecasting the health and economic impacts of stroke decades into the future is inherently challenging given the levels of uncertainty involved, but these estimates are indicative of the ever-increasing burden we will see in the years ahead unless urgent, effective action is taken,” Feigin stated.
The study predicts that, taking into account population growth and aging in most countries, the annual global death toll from stroke will increase by 50%, surging from 6.6 million in 2020 to 9.7 million in 2050. LMICs are expected to see a significant rise in stroke deaths, widening the gap with HICs. Asia bears the greatest share of global stroke deaths, expected to increase from 61% in 2020 to around 69% by 2050.
Sub-Saharan African countries will also experience an increase in annual stroke deaths, rising from 6% in 2020 to 8% in 2050. Professor Jeyaraj Pandian, President-Elect of the World Stroke Organization, highlights the need to investigate the causes behind this increase, including uncontrolled risk factors such as high blood pressure and the lack of stroke prevention and care services in these regions.
Without prompt action, stroke deaths in Southeast Asia, East Asia, and Oceania could increase by almost 2 million deaths, from 3.1 million in 2020 to potentially 4.9 million in 2050. The study also indicates that while the global death rate among people aged over 60 years is predicted to decrease by 36%, it will fall by less than 25% among those under 60 years. This difference may be related to increasing levels of diabetes and obesity in younger age groups.
Economic forecasts paint a dire picture, with the combined cost of stroke, including direct costs and income losses, expected to rise from USD 891 billion per year in 2017 to USD 2.31 trillion in 2050. The majority of these economic impacts will be concentrated in Asia and Africa.
Projections also suggest substantial increases in direct costs and income losses related to stroke in middle-income countries, as well as increased direct costs in HICs. Even low-income countries will see greater economic impacts, but their overall share in global costs is expected to remain relatively small due to their lower population and fewer stroke cases.
To identify the key barriers and facilitators for high-quality stroke surveillance, prevention, acute care, and rehabilitation, the commission conducted in-depth interviews with 12 stroke experts from both HICs and LMICs. The major barriers identified include low awareness of stroke and its risk factors, which encompass high blood pressure, diabetes mellitus, high cholesterol, obesity, unhealthy diet, sedentary lifestyle, and smoking. There is also a shortage of surveillance data on stroke risk factors, events, management, and outcomes.
On a positive note, the study points out that well-established stroke organizations and networks can help build capacity for stroke care and research. Universal healthcare systems that provide population-wide access to evidence-based stroke care are identified as significant facilitators in the fight against stroke.
In conclusion, this study provides a stark warning about the escalating global burden of stroke, particularly in LMICs, and underscores the urgent need for comprehensive and sustained efforts to address this crisis.
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