Data from 188 countries from 1990 through 2013 suggest that more than 90% of the stroke burden is attributable to modifiable risk factors, and achieving control of behavioral and metabolic risk factors could avert more than three-quarters of the global stroke burden. Air pollution has emerged as a significant contributor to global stroke burden, especially in low-income and middle-income countries. The data were used to estimate the population-attributable fraction (PAF) of stroke-related disability-adjusted life-years (DALYs) associated with potentially modifiable environmental, occupational, behavioral, physiological, and metabolic risk factors in different age and sex groups worldwide. Globally, 90·5% of the stroke burden (as measured in DALYs) was attributable to the modifiable risk factors analyzed, including 74·2% due to behavioral factors (smoking, poor diet, and low physical activity). Clusters of metabolic factors (high SBP, high BMI, high fasting plasma glucose, high total cholesterol, and low glomerular filtration rate; 72·4%) and environmental factors (air pollution and lead exposure; 33·4%) were the second and third largest contributors to DALYs. Globally, 29·2% of the burden of stroke was attributed to air pollution. While most risk factors showed a downward trend in their contribution to stroke, a diet high in sugar-sweetened beverages was the exception. Source: http://www.thelancet.com/
来自188个国家从1990年到2013年的数据表明,90%以上的中风是由可改变的危险因素所致,通过控制行为和代谢性危险因素可能避免全球超过四分之三的中风负担。空气污染已成为一个导致全球中风负担的显著因素,尤其是在低收入和中等收入国家。这些数据被用来估计在全球不同年龄和性别中,与潜在的可变环境,职业,行为,生理和代谢性危险因素相关的有关中风伤残校正寿命的人群归因分数。从全球来看,90·5%的中风负担(以伤残校正寿命衡量)是由可改变的危险因素所致,包括74·2%是由于行为因素(吸烟,不良饮食和体力活动少)。集群代谢性因素(高收缩压,高体重指数,高空腹血糖,高胆固醇和低肾小球滤过率占72·4%)和环境因素(空气污染和暴露于铅; 占33·4%)则分别为伤残校正寿命的第二和第三大因素。全球范围内,中风负担的29·2%归因于空气污染。虽然大多数风险因素对中风的影响呈下降趋势,而高含糖饮料饮食例外。来源:http://www.thelancet.com/