ArticleArchives of Iranian medicine2026
Global, Regional, and National Burden of Stroke Attributable to High Systolic Blood Pressure in Adults Aged 45 Years and Above From 1990 to 2021, with Projections to 2045: A Systematic and Comprehensive Analysis of the Global Burden of Disease Study 2021.
Article in Archives of Iranian medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionStroke remains a leading cause of death and disability worldwide, with high systolic blood pressure (HSBP) being a major modifiable risk factor. This study aimed to assess global trends, age- and SDI-specific patterns, and future projections of the stroke burden attributable to HSBP among adults aged≥45 years from 1990 to 2021.
methodsData were obtained from the Global Burden of Disease Study 2021. Mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) were analyzed across sex, age, and socio-demographic index (SDI) strata. Estimated annual percentage change (EAPC) was used to quantify temporal trends, and the ARIMA model was applied for projections to 2045.
resultsIn 2021, global HSBP-attributable stroke deaths and DALYs among adults aged≥45 years reached 4.12 million and 86.18 million, respectively. From 1990 to 2021, the number of deaths increased by 51.5% and DALYs by 47.9%, despite declines in ASMR (EAPC=-1.72) and ASDR (EAPC=-1.61). Mortality and DALY rates increased with age in all SDI regions, peaking at 70-79 years, with low-SDI regions showing the highest rates and an earlier peak age. High-SDI regions recorded the lowest burden and largest declines in ASMR and ASDR. Projections indicate a continued global decline in mortality rates through 2045, with a faster reduction in females.
conclusionAlthough the global age-standardized burden of HSBP-attributable stroke has declined, absolute cases continue to rise, especially among older adults and in low-SDI regions, highlighting the need for targeted prevention.
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