10 modifiable risk factors are responsible for 90% of strokes worldwide

An international case-control study in 32 countries, published in The Lancet, looks at different risk factors and determines the proportion of strokes which would be cut if the risk factor were to disappear. The number of strokes could be roughly halved (48%) if hypertension was eliminated, cut by more than a third (36%) if people were physically active, and reduced by almost one fifth (19%) if diets would improve. Additionally, further cutbacks could be achieved by eliminating smoking (12%), diabetes (6%), and alcohol (6%). Many of the risk factors are associated with each other, and when combined together, the total from all ten risk factors equals an astonishing 91%.

The Global Burden of Stoke Source:WHO

The Global Burden of Stoke Source:WHO

The significance of risk factors seems to vary by region. The importance of hypertension ranges from 40% in Western Europe, North America, and Australia to 60% in Southeast Asia. Alcohol as a risk factor has the highest impact in Africa and Asia with a little over 10%.

These important regional variations in the relative importance of most individual risk factors for stroke can contribute to worldwide variations in frequency and case-mix of stroke. The findings support developing both global and region-specific programmes to prevent stroke. Stroke is a leading cause for death and disability, particularly in low and middle-income countries.

For more information on hypertension please find NCDAPA article World Hypertension Day 2016.

The study can be found here