Differences in the burden and temporal trend of stroke in the Belt and Road Initiative countries, 1990-2021.

OBJECTIVES: To analyze the differences in the burden and trend of disability caused by stroke in "Belt and Road" ("B&R") countries from 1990 to 2021. METHODS: We applied GBD 2021 to compare stroke incidence, mortality, the years lived with disability (YLDs) and disability-adjusted life-years (DALYs) from 1990 to 2021 in the "B&R" countries. The average annual percent change (AAPC) was used to analyze the temporal trends of age-standardized YLDs rate of stroke from 1990 to 2021 by Joinpoint regression analysis. RESULTS: China, India and Indonesia had the highest absolute stroke numbers of stroke. From 1990 to 2021, the AAPC values of age-standardized metrics showed a downward trend in most of "B&R" countries. Turkmenistan had the highest increase in AAPCs of age-standardized YLDs rate for men (AAPC=0.60 %), while for women Philippines had the highest increase (AAPC=0.57 %). For under 15 years, YLDs due to stroke in most member states showed a downward trend, while increasing trends were noted in Saudi Arabia and Turkmenistan. Globally, metabolic, environmental/occupational and behavioral risk factors showed significant reductions (AAPC: -0.12 %, -0.92 %, and -0.53 %, respectively). CONCLUSIONS: The overall burden of stroke remains enormous, with regional, age and gender disparities. Enhanced health cooperation among B&R countries is warranted.