Global Stroke Burden to Surge: The Lancet Neurology Commission Predicts 50% Rise in Mortality by 2050
A new study paints a grim picture of the future, especially for low- and middle-income countries, and calls for immediate pragmatic action.
An international commission of experts, convened by the World Stroke Organization (WSO) and The Lancet Neurology journal, has published a comprehensive report with an alarming forecast regarding the global burden of stroke. According to their analysis, by 2050, annual stroke mortality worldwide will increase by 50%, reaching 9.7 million cases compared to 6.6 million in 2020. The number of disability-adjusted life years (DALYs) due to stroke will also increase by 31% – from 144.8 million to 189.3 million over the same period.
A Widening Gap and Younger Patients
Of particular concern is that the main impact of this growing burden will fall on low- and middle-income countries (LMICs). If in 2020 these countries accounted for 86% of all stroke deaths and 89% of DALYs, by 2050, these figures are projected to increase to 91% and 92% respectively. This highlights the deepening inequality in access to stroke prevention and treatment.
Furthermore, the Commission draws attention to the alarming trend of increasing stroke incidence among young and middle-aged people (under 55 years) worldwide. This indicates the need for an urgent review and strengthening of prevention strategies targeting younger age groups.
The Four Pillars of Stroke Management
The report is based on the concept of the “stroke quadrangle,” which includes four key areas for reducing the global burden of this disease:
- Surveillance: Monitoring risk factors and healthcare services.
- Prevention: Reducing exposure to modifiable risk factors.
- Acute Care: Planning medical services and capacity building.
- Rehabilitation: Access to multidisciplinary care and support.
Key Challenges and Pragmatic Solutions
The Commission identified several barriers to effective stroke management, including:
- Insufficient Surveillance: Especially in LMICs, where a lack of quality data on risk factors, cases, and outcomes hinders planning and evaluation of measures. The creation of low-cost surveillance systems, integrated into existing non-communicable disease (NCD) monitoring systems, is recommended.
- Gaps in Prevention: Uncontrolled arterial hypertension remains one of the main risk factors. Globally, only about 23% of women and 18% of men with hypertension achieve adequate blood pressure control. The Commission calls for the implementation of population-wide primary and secondary prevention strategies, including the use of digital technologies for screening and motivation, as well as the wider use of polypills where indicated.
- Limited Access to Acute Care: The establishment of stroke units with the capability for reperfusion therapy (thrombolysis and thrombectomy) is crucial for improving outcomes. However, access to such services, especially thrombectomy, is severely limited in LMICs.
- Deficit in Rehabilitation Services: Multidisciplinary rehabilitation aimed at restoring lost functions and improving quality of life is underdeveloped, particularly in LMICs. There is a shortage of trained personnel and specialized equipment.
The economic consequences of stroke are also enormous: annual direct and indirect costs already exceed US$891 billion and could rise to US$2.31 trillion by 2050 if decisive steps are not taken.
Call to Action
The Commission emphasizes that many strokes and their devastating consequences can be prevented. The proposed pragmatic solutions, adapted to local conditions, can significantly reduce the burden of stroke. This requires urgent, coordinated action at the global, national, and regional levels, involving governments, healthcare professionals, academia, and the public. Experts propose creating a global “ecosystem” to facilitate the implementation of these recommendations and achieve the Sustainable Development Goal target of reducing the burden of NCDs.
Stroke is not only a medical but also a serious socio-economic problem that requires a comprehensive and immediate response from the entire global community.
