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Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean
BACKGROUND: Stroke burden characterization studies in low‐ and middle‐income countries are scarce. We estimated the burden of stroke and its risk factors in Latin America and the Caribbean (LAC). METHODS AND RESULTS: We extracted GBD (Global Burden of Disease) study 2019 data on overall stroke and 3...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673624/ https://www.ncbi.nlm.nih.gov/pubmed/36285788 http://dx.doi.org/10.1161/JAHA.122.027044 |
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author | Pacheco‐Barrios, Kevin Giannoni‐Luza, Stefano Navarro‐Flores, Alba Rebello‐Sanchez, Ingrid Parente, Joao Balbuena, Ana de Melo, Paulo S. Otiniano‐Sifuentes, Ricardo Rivera‐Torrejón, Oscar Abanto, Carlos Alva‐Diaz, Carlos Musolino, Patricia L. Fregni, Felipe |
author_facet | Pacheco‐Barrios, Kevin Giannoni‐Luza, Stefano Navarro‐Flores, Alba Rebello‐Sanchez, Ingrid Parente, Joao Balbuena, Ana de Melo, Paulo S. Otiniano‐Sifuentes, Ricardo Rivera‐Torrejón, Oscar Abanto, Carlos Alva‐Diaz, Carlos Musolino, Patricia L. Fregni, Felipe |
author_sort | Pacheco‐Barrios, Kevin |
collection | PubMed |
description | BACKGROUND: Stroke burden characterization studies in low‐ and middle‐income countries are scarce. We estimated the burden of stroke and its risk factors in Latin America and the Caribbean (LAC). METHODS AND RESULTS: We extracted GBD (Global Burden of Disease) study 2019 data on overall stroke and 3 subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) for 20 LAC countries. We estimated absolute and age‐standardized rates of disability‐adjusted life years, years of life lost, years lived with disability, and deaths. The population‐attributable fractions of 17 risk factors were estimated. All analyses were performed at regional and national levels by stroke subtype, sex, and age subgroups. In 2019, the LAC region had the fourth largest stroke burden worldwide (6.8 million disability‐adjusted life years), predominantly attributable to premature deaths (89.5% of disability‐adjusted life years). Intracerebral hemorrhage was the primary cause of the overall stroke burden (42% of disability‐adjusted life years), but ischemic stroke was the leading cause of disability (69% of total years lived with disability). Haiti and Honduras had the highest age‐standardized rates. Older adults and men had the largest burdens, although women had the highest rate of disability. Socioeconomic development level did not influence the burden. The major risk factor clusters were metabolic (high systolic blood pressure [population‐attributable fraction=53%] and high body mass index [population‐attributable fraction=37%]), which were more influential in hemorrhagic events, women, and older adults. Household air pollution was an important risk factor in low‐income countries in LAC. CONCLUSIONS: The stroke burden and stroke‐related mortality in LAC are higher than the worldwide averages. However, stroke is a highly preventable disease in this region. Up to 90% of the burden could be reduced by targeting 2 modifiable factors: blood pressure and body mass index. Further research and implementation of primary and secondary prevention interventions are needed, as well as integrated national stroke care programs for acute, subacute, and rehabilitation management in LAC. |
format | Online Article Text |
id | pubmed-9673624 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96736242022-11-21 Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean Pacheco‐Barrios, Kevin Giannoni‐Luza, Stefano Navarro‐Flores, Alba Rebello‐Sanchez, Ingrid Parente, Joao Balbuena, Ana de Melo, Paulo S. Otiniano‐Sifuentes, Ricardo Rivera‐Torrejón, Oscar Abanto, Carlos Alva‐Diaz, Carlos Musolino, Patricia L. Fregni, Felipe J Am Heart Assoc Original Research BACKGROUND: Stroke burden characterization studies in low‐ and middle‐income countries are scarce. We estimated the burden of stroke and its risk factors in Latin America and the Caribbean (LAC). METHODS AND RESULTS: We extracted GBD (Global Burden of Disease) study 2019 data on overall stroke and 3 subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) for 20 LAC countries. We estimated absolute and age‐standardized rates of disability‐adjusted life years, years of life lost, years lived with disability, and deaths. The population‐attributable fractions of 17 risk factors were estimated. All analyses were performed at regional and national levels by stroke subtype, sex, and age subgroups. In 2019, the LAC region had the fourth largest stroke burden worldwide (6.8 million disability‐adjusted life years), predominantly attributable to premature deaths (89.5% of disability‐adjusted life years). Intracerebral hemorrhage was the primary cause of the overall stroke burden (42% of disability‐adjusted life years), but ischemic stroke was the leading cause of disability (69% of total years lived with disability). Haiti and Honduras had the highest age‐standardized rates. Older adults and men had the largest burdens, although women had the highest rate of disability. Socioeconomic development level did not influence the burden. The major risk factor clusters were metabolic (high systolic blood pressure [population‐attributable fraction=53%] and high body mass index [population‐attributable fraction=37%]), which were more influential in hemorrhagic events, women, and older adults. Household air pollution was an important risk factor in low‐income countries in LAC. CONCLUSIONS: The stroke burden and stroke‐related mortality in LAC are higher than the worldwide averages. However, stroke is a highly preventable disease in this region. Up to 90% of the burden could be reduced by targeting 2 modifiable factors: blood pressure and body mass index. Further research and implementation of primary and secondary prevention interventions are needed, as well as integrated national stroke care programs for acute, subacute, and rehabilitation management in LAC. John Wiley and Sons Inc. 2022-10-26 /pmc/articles/PMC9673624/ /pubmed/36285788 http://dx.doi.org/10.1161/JAHA.122.027044 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Pacheco‐Barrios, Kevin Giannoni‐Luza, Stefano Navarro‐Flores, Alba Rebello‐Sanchez, Ingrid Parente, Joao Balbuena, Ana de Melo, Paulo S. Otiniano‐Sifuentes, Ricardo Rivera‐Torrejón, Oscar Abanto, Carlos Alva‐Diaz, Carlos Musolino, Patricia L. Fregni, Felipe Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title | Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title_full | Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title_fullStr | Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title_full_unstemmed | Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title_short | Burden of Stroke and Population‐Attributable Fractions of Risk Factors in Latin America and the Caribbean |
title_sort | burden of stroke and population‐attributable fractions of risk factors in latin america and the caribbean |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673624/ https://www.ncbi.nlm.nih.gov/pubmed/36285788 http://dx.doi.org/10.1161/JAHA.122.027044 |
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