Trends of stroke attributable to high sodium intake at the global, regional, and national levels from 1990 to 2019: a population-based study

Objectives: High sodium intake is associated with a higher risk of stroke. However, global patterns and trends in the stroke burden attributable to high sodium intake have not been systematically assessed. Methods: We used the numbers and age-standardized mortality rate (ASMR), and disability-adjusted life years (DALYs) rate (ASDR) of the stroke burden attributable to high sodium intake by sex, socio-demographic index (SDI), and country, obtained from the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percentage changes (EAPCs) to assess the trends of ASMR and ASDR of the disease burden attributable to high sodium intake between 1990 and 2019. We further calculated the contribution of changes in population growth, population aging, and mortality or DALYs to changes in total stroke deaths and DALYs. Results: From 1990 to 2019, the global burden of stroke attributable to high sodium intake changed significantly, from a universal burden in Asia and Europe to one that mainly affected some countries in Asia and Oceania. This change was due to the combined effects of demographic changes and changes in mortality or DALY rates. For countries in Asia and Oceania, the effects of population aging and population growth outweighed the effects of declining mortality and DALY rates, resulting in an absolute increase in strokes attributable to high sodium intake. Conclusion: Although the age-standardized global stroke burden attributable to high sodium intake has declined from 1990 to 2019, the burdens in some Asia and Oceania countries, particularly China, remain high.