Global, regional and national burden of ischemic stroke attributed to high low-density lipoprotein cholesterol, 1990-2019:A decomposition analysis and age-period-cohort analysis

J Cereb Blood Flow Metab. 2024 Apr;44(4):527-541. doi: 10.1177/0271678X231211448. Epub 2023 Oct 27.

Abstract

High levels of low-density lipoprotein cholesterol (LDL-C) have been associated with an augmented mortality of ischemic stroke. The yearly deaths and mortality data of IS-hLDL-C were derived from the global burden of disease 2019 dataset. The joinpoint, age-period-cohort and decomposition analysis were utilized to evaluate the long-term patterns in the disease burden of IS-hLDL-C, and the effects of population growth and aging. Globally, in 2019, 0.61 million ischemic stroke-related deaths were attributable to high LDL-C, with the highest death burden in the high-middle socio-demographic index (SDI) region. From 1990 to 2019, the age-standardized death rate (ASDR) for IS-hLDL-C exhibited a downward trend, with an average annual percentage change of -1.69 [95% confidence interval: -1.90, -1.48)]. The fastest decreasing trends in ASDR were experienced in the high SDI region. In 119 (58.33%) countries, aging increased the disease burden of hLDL-IS, and population growth increased the disease burden of IS-hLDL-C in 163 (79.90%) countries. The trend in disease burden of IS-hLDL-C exhibited variation across countries and regions, particularly in territories with high to middle high SDI. Aging in upper to middle-income countries and population growth in low to middle-income countries further offset endeavors to reduce the burden of ischemic stroke deaths.

Keywords: High low-density lipoprotein cholesterol; age-period-cohort analysis; decomposition analysis; epidemiology; ischemic stroke; joinpoint analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Cohort Studies
  • Global Burden of Disease
  • Humans
  • Ischemic Stroke*

Substances

  • Cholesterol, LDL
  • Cholesterol, HDL