Global Burden of Stroke

February 2018: Feigin et al (2016) Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurology, 15(9), 913–24 S1474-4422(16)30073-4

I thought I should start off this year talking about stroke prevention. As the old adage says: “Prevention is better than cure”, and this is certainly the case for stroke. Sure, I have digressed from stroke recovery in its purest sense, but actually, all those who have experienced stroke and/or transient ischemic attack or TIA, are at high risk of experiencing another stroke. Therefore, although risk and prevention are not ordinarily a component of the stroke recovery programs discourse, perhaps it should be, because, as Feigin et al found, “90.5% (95% UI 88.5-92.5) of the stroke burden was attributable to the modifiable risk factors analysed, including 74.2% (95% UI 70.7-76.7) due to behavioural factors (smoking, diet and low physical activity)”. If you think the blame lies mainly at the feet of those who appear to have unhealthy lifestyles, you may be surprised to read that these researchers found nearly 30% of all strokes are attributable to air pollution!

It’s important that all health professionals have an understanding of the factors that place some people at higher risk of stroke than others. The articles published by this research collaboration are, in my humble opinion, the most significant publications that those of us working in stroke, could be reading.  As with all Journal Club reviews, you’ll find the abstract and my Humble Opinion, under Journal Club 2018 and under the Global Burden of Disease option in the drop-down menu. This article is freely available from

I’m excited about starting the year on such a significant article. I’m also looking forward to our journeying together in 2018, Isobel

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