Stroke and stroke risk factors as disease burden

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61.001; 616.831

S. Ozturk


Selcuk University, Faculty of Medicine, Selcuklu-Konya, 42130, Turkey


Stroke is the most common cause of disability and death in the world. Cardiovascular disease rates increase with age (10.9 % for people aged 20–30 years and 85.3 % for people older than 80 years). Coronary heart diseases is the leading cause of deaths attributable to cardiovascular diseases in the United States, followed by stroke, high BP, HF, diseases of the arteries, and other cardiovascular diseases. The report on the global burden of neurological disorders has shown that hemorrhagic stroke accounted for 35.7 % in it, and ischemic stroke, 22.4 %. Seven indicators are important and strategic to prevent cardiovascular disorders; they include healthy diet, sufficient physical activity, smokingstatius, BMI, cholesterol level, blood pressure, and glucose in blood on a fasting stomach. These indicators are associated with healthy behavior (diet quality, PA, smoking, BMI) which are as important as health factors (blood cholesterol, BP, blood glucose). There is a strong protective association between ideal cardiovascular health indicators and many clinical and preclinical conditions including premature all-cause mortality, stroke, CVD mortality, ischemic heart disease mortality, HF, deep venous thromboembolism, and pulmonary embolism. Atrial fibrillation, metabolic syndrome, renal failure, and sleep apnea are important risk factors which are modifiable and treatable. Air pollution has been reported as an increasing and very important risk factor for stroke. COVID-19 has been reported as another new stroke risk factor during the pandemic. Future targets must include each cardiovascular health indicator to decrease stroke risk burden and stroke risk.

stroke, cardiovascular diseases, health indicators, risk factors, disease burden
Ozturk S. Stroke and stroke risk factors as disease burden. Health Risk Analysis, 2021, no. 4, pp. 146–150. DOI: 10.21668/health.risk/2021.4.16.eng
  1. Virani S.S., Alonso A., Aparicio H.J., Benjamin E.J., Bittencourt M.S., Callaway C.W., Carson A.P., Chamberlain A.M. [et al.]. Heart Disease and Stroke Statistics – 2021 Update: A Report From the American Heart Association. Circulation, 2021, vol. 14, no. 8, pp. e254–e743. DOI: 10.1161/CIR.0000000000000950
  2. Chin J.H., Vora N. The global burden of neurologic diseases. Neurology, 2014, vol. 83, no. 4, pp. 349–351. DOI: 10.1212/WNL.0000000000000610
  3. Mills K.T., Bundy J.D., Kelly T.N., Reed J.E., Kearney P.M., Reynolds K., Chen J., He J. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation, 2016, vol. 134, no. 6, pp. 441–500. DOI: 10.1161/CIRCULATIONAHA.115.018912
  4. GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet, 2017, vol. 389, no. 10082, pp. 1885–1906. DOI: 10.1016/S0140-6736(17)30819-X
  5. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva, Switzerland, World Health Organization, 2009, 63 p.
  6. Powles J., Fahimi S., Micha R., Khatibzadeh S., Shi P., Ezzati M., Engell R.E., Lim S.S. [et al.]. Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open, 2013, vol. 3, no. 12, pp. e003733. DOI: 10.1136/bmjopen-2013-003733
  7. My Life Check. Life’s Simple 7. American Heart Association. Available at: (26.04.2021).
  8. Molnar M.Z., Mucsi I., Novak M., Szabo Z., Freire A.X., Huch K.M., Arah O.A., Ma J.Z. [et al.]. Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans. Thorax, 2015, vol. 70, no. 9, pp. 888–895. DOI: 10.1136/thoraxjnl-2015-206970
  9. GBD 2013 Risk Factors Collaborators, Forouzanfar M.H., Alexander L., Anderson H.R., Bachman V.F., Biryukov S., Brauer M., Burnett R. [et al.]. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, vol. 386, no. 10010, pp. 2287–2323. DOI: 10.1016/S0140-6736(15)00128-2
  10. Global Status Report on Noncommunicable Diseases 2014. WHO, 2014. Available at: (26.04.2021).
  11. Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol., 2017, vol. 16, no. 11, pp. 877–897. DOI: 10.1016/S1474-4422(17)30299-5
  12. Thrift A.G., Howard G., Cadilhac D.A., Howard V.J., Rothwell P.M., Thayabaranathan T., Feigin V.L., Norrving B., Donnan G.A. Global stroke statistics: An update of mortality data from countries using a broad code of “cerebrovascular diseases”. Int. J. Stroke, 2017, vol. 12, no. 8, pp. 796–801. DOI: 10.1177/1747493017730782
  13. Feigin V.L., Norrving B., Mensah G.A. Global Burden of Stroke. Circ. Res., 2017, vol. 120, no. 3, pp. 439–448. DOI: 10.1161/CIRCRESAHA.116.308413
  14. Roth G.A., Johnson C., Abajobir A., Abd-Allah F., Abera S.F., Abyu G., Ahmed M., Aksut B. [et al.]. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J. Am. Coll. Cardiol., 2017, vol. 70, no. 1, pp. 1–25. DOI: 10.1016/j.jacc.2017.04.052
  15. Mondal S., Quintili A.L., Karamchandani K., Bose S. Thromboembolic disease in COVID-19 patients: A brief narrative review. J. Intensive Care, 2020, vol. 8, pp. 70. DOI: 10.1186/s40560-020-00483-y
  16. Federico A. Brain Awareness Week, COVID-19 infection and Neurological Sciences. Neurol. Sci., 2020, vol. 41, no. 4, pp. 747–748. DOI: 10.1007/s10072-020-04338-0
  17. Norrving B., Barrick J., Davalos A., Dichgans M., Cordonnier C., Guekht A., Kutluk K., Mikulik R. [et al.]. Action Plan for Stroke in Europe 2018–2030. European Stroke Journal, 2018, vol. 3, no. 4, pp. 309–336. DOI: 10.1177/2396987318808719

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