ReviewGlobal epidemiology2025
Epidemiology of stroke in Pakistan and its provinces, 1990-2021: Findings from the global burden of disease study 2021.
Review in Global epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Leukocytosis in acute stroke: A prospective study from an emergency department setting.Pakistan journal of medical sciences · 2026Article
- Adaptation of the Quick Aphasia Battery into Urdu and establishment of its psychometric properties.PloS one · 2026Article
- Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Despite stroke being a leading cause of death in Pakistan, no study has comprehensively analyzed national and regional trends over time. This gap limits understanding of the evolving burden and underlying risk factors. Methods: We analyzed regional stroke trends in Pakistan from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data. Age-standardized incidence, prevalence, mortality, disability-adjusted life years (DALYs), and 18 modifiable risk factors were analyzed across provinces. Joinpoint regression identified temporal trends through annual percent changes (APCs), and population attributable fractions (PAFs) quantified risk contributions. All estimates incorporated 95 % uncertainty intervals and underwent sensitivity testing to ensure robustness. Findings: In 2021, stroke was the second leading cause of death in Pakistan, responsible for 99,759 deaths, with an incidence of 153 and a prevalence of 1088 per 100,000 population. Age-standardized rates for incidence, prevalence, mortality, and DALYs declined overall from 1990 to 2021 (ASIR AAPC: -0.15 %), though reductions were modest. Regional trends showed the steepest declines in Islamabad and Punjab, while Balochistan experienced an increase in mortality (ASMR AAPC: +0.03 %) and DALYs (+0.05 %). Sex-specific trends showed greater declines in incidence and mortality among females, while DALY reductions were modest in both sexes, reflecting ongoing disability. High systolic blood pressure was the leading risk factor for stroke mortality (25.2 per 100,000) and DALYs (674.9 per 100,000), followed by household air pollution, ambient particulate matter, and high fasting glucose. These findings reflect the combined influence of cardiometabolic, environmental, and behavioral risks on Pakistan's evolving stroke burden. Interpretation: Despite modest improvements, stroke remains a major health challenge in Pakistan, with rising long-term disability and stark regional inequalities. Strengthening prevention, equitable access, and post-stroke care is essential to curb the growing burden.
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