Burden of stroke and risk attributed to smoking in Iran: A Global Burden of Disease Study 2021

Objectives: This study aimed to provide a report and update on the burden of stroke in Iran and globally and to provide new estimates of disability-adjusted life years (DALYs) and stroke-related deaths attributed to smoking. Materials and methods: This study was conducted in accordance with the Global Burden of Disease Study 2021. All age and age-standardized estimates of stroke attributed to smoking were calculated for DALYs and death between the years 1990 and 2021. Estimates were based on per 100,000 individuals. The 95% uncertainty interval (UI) was reported for each of the reported estimates. Results: In 2021, 93 (95% UI 89-99) million stroke cases were detected globally, and 787,178 (95% UI 726,667-855,320) cases were detected in Iran. In 2021, global age-standardized death rate of stroke per 100,000 individuals was 87.45 (95% UI 78.92-94.14), while it was 63.89 (95% UI 56.76-69.69) in Iran. Age-standardized DALYs of stroke per 100,000 individuals in 2021 was 1,886.20 (95% UI 1,738.99-2,017.90) globally and 1,229.18 (95% UI 1,119.52-1,332.60) in Iran. Although the prevalence, incidence, mortality, and disability rates of stroke globally and in Iran decreased between 1990 and 2021, the number of cases increased. In 2021, tobacco use was responsible for over one million deaths worldwide (1,077,804 [95% UI 865,541-1,320,753]), including 4,007 (95% UI 3,159-4,972) in Iran. Compared to 1990, there was an increase in the number of deaths caused by smoking globally (0.52[95% UI 0.31-0.79]) and in Iran (0.20 [95% UI 0.06-0.35]). Conclusion: The burden caused by stroke on the health system can be significant. Therefore, it is necessary to address the preventable risk factors of stroke, including smoking, which is a major risk factor.