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A new report predicts the number of people dying from strokes will increase 50% by 2050, particularly among younger people. JazzIRT/Getty Images
  • A new report predicts the number of people dying from strokes will increase 50% by 2050, especially among younger people.
  • Many strokes are preventable with lifestyle modifications, although pollution and climate stressors coiuld be a factor in the increase.
  • People in lower- and middle-income regions and lower-income areas within high-income countries will be most affected.

The number of people experiencing strokes is rising rapidly worldwide, according to a new report from the World Stroke Organization-Lancet Neurology Commission.

Life-changing disabilities are common in those who survive a stroke.

The report shows that the number of people who will die from strokes worldwide is likely to rise 50% by 2050, with 10 million people dying from stroke yearly.

Currently, 15 million people globally have a stroke each year. 5 million of these individuals die, while another 5 million continue to live with stroke-related disabilities that impact their families and communities. Stroke is the second leading cause of death worldwide, after ischemic heart disease.

Lower- and middle-income countries are most profoundly affected by the increase in strokes, as are poorer areas within higher-income countries.

In addition to the burden placed by strokes on people and those surrounding them, they also pose a significant financial cost for healthcare systems.

Additionally, the report notes that strokes are rising rapidly among adults younger than 55.

According to the Centers for Disease Control and Prevention (CDC), many strokes are preventable with lifestyle changes, such as:

Treatment can limit the negative consequences for people who receive appropriate medical attention in the first few hours after a stroke. Rehabilitation interventions can improve the quality of life for survivors by reducing physical damage from a stroke.

The Commission’s purpose is to provide a global wake-up call. An executive summary of the findings is published in The Lancet Neurology.

Numerous factors contribute to the rise in stroke incidence, varying in different parts of the world.

In most cases, poor dietary and lifestyle choices increase a person’s stroke risk.

One of the more significant stroke drivers is unmanaged hypertension, which is “under-treated and under-detected around the world,” said Columbia University neurologist Dr. Joshua Z. Willey.

Dr. Ziyad Al-Aly, chief of research and development at the VA St. Louis Health Care System, cited the global obesity epidemic as a leading cause of stroke. The incidence of diabetes — another stroke risk factor — is also rising.

Monash University’s associate professor Monique Kilkenny noted that “worsening environmental and air quality issues,” including pollution and climate stressors, are contributing to the increase in stroke prevalence.

In addition, Dr. Al-Aly said there’s been an increase in stroke cases after the COVID-19 pandemic and said that COVID should be considered a risk factor for stroke. “This may also lead to a rise in the prevalence of strokes,” he said.

Dr. Willey pointed out that stroke is a significant factor in healthcare-related racial disparities in the United States.

Prof. Kilkenny explained that people who have low socioeconomic status face a higher risk of stroke due to:

  • limited access to quality healthcare disease prevention services
  • inadequate funding
  • a lack of systems for risk surveillance to inform public health planning

Telemedicine could help increase access to preventive care

Dr. Al-Aly said recent technological advancements like telemedicine should be leveraged to improve access to care. He noted that “providing care in remote areas, rural areas, areas that are traditionally underserved” could improve access for patients to connect with preventive care.

Dr. Willey noted, “Telemedicine has been mostly used in stroke care for delivery of acute therapeutics, such as thrombolysis or arranging for surgical interventions in a rapid manner, and has been very helpful in rural communities and after hours where/when there is lower access to care to specialists.”

Still, telemedicine requires sufficient technology — internet-connected devices — in the home, which may not be available to residents of low-income areas.

In low-income communities where internet access is available, Dr. Al-Aly said, it “holds the potential to help with primary care in under-served communities in areas so as to potentially improve the detection and treatment of hypertension, diabetes, and other risk factors.”

The projected 50% increase in stroke incidence is an alarming figure, but Prof. Kilkenny suggested a way forward:

“Prevention is the key priority to reduce the burden of stroke. Around the world, drastic actions are required, and The Lancet Neurology paper clearly outlines the two most important priorities that, I believe, need to be undertaken urgently:

  1. Governments must allocate a fixed proportion of their annual healthcare funding for prevention of stroke and related non-communicable diseases. This funding could come from taxation of tobacco, salt, alcohol, and sugar.
  2. Raise public awareness and take action to encourage a healthy lifestyle and prevent stroke via population-wide deployment of digital technologies.”

Dr. Al-Aly noted that rising stroke prevalence is “not on the radar screen of politicians” compared to obesity and other chronic conditions.”

“This is the great American tragedy,” Dr. Al-Aly said, “that we seem unconcerned with prevention effort. So much of our healthcare infrastructure is focused on treating disease after it already happened, not on preventing disease.”

“This is one of the many reasons American healthcare costs so much and delivers poor results. We need greater focus on prevention,” he concluded.