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The burden of stroke, ischaemic heart disease, and dementia in Africa, 1990–2021: an ecological analysis of the Global Burden of Disease 2021
Abolfazl Avan, Vladimir Hachinski, Wepnyu Yembe Njamnshi, Neil Andersson, Alfred Kongnyu NJAMNSHI. The Lancet Global Health, 2025-06-25
Topic: Risk, prevention and care in population studies
In Africa in 2021, 17·3 (95% UI 15·5-19·2) million DALYs were lost due to strokes, 17·6 (15·5-19·6) million were lost due to ischaemic heart diseases, and 1·8 (0·8-4·0) million were lost due to dementia. New and prevalent cases doubled from 1990 to 2021, with two-thirds of DALYs occurring before age 70 years. Among five continents, Africa had the highest age-standardised DALY rates per 100 000 population for stroke (2628·1 [2367·4-2893·0]) and ischaemic heart disease (2743·5 [2451·8-3033·6]), and the lowest for dementia (423·4 [190·6-934·6]). Regionally, central and southern Africa showed higher stroke DALY rates, northern Africa had the highest rates for ischaemic heart disease, and central and northern Africa had the highest rates for dementia. Among 12 modifiable risk factors, high systolic blood pressure, unhealthy diet, and air pollution contributed most to DALYs. Stroke DALYs rose prominently due to high BMI, high fasting plasma glucose, high LDL cholesterol, low physical activity, and high systolic blood pressure. Africa faces substantial challenges from stroke, heart disease, and dementia, including the highest DALY rates globally, with worsening trends over the past three decades, including younger ages of onset. These patterns, coupled with limited health resources, necessitate urgent and targeted strategies to protect, preserve, and promote brain health in Africa. FUNDING: Weston Family Foundation.
Key findings
- In Africa in 2021, 17·3 (95% UI 15·5-19·2) million DALYs were lost due to strokes, 17·6 (15·5-19·6) million were lost due to ischaemic heart diseases, and 1·8 (0·8-4·0) million were lost due to dementia.
- New and prevalent cases doubled from 1990 to 2021, with two-thirds of DALYs occurring before age 70 years.
- Among five continents, Africa had the highest age-standardised DALY rates per 100 000 population for stroke (2628·1 [2367·4-2893·0]) and ischaemic heart disease (2743·5 [2451·8-3033·6]), and the lowest for dementia (423·4 [190·6-934·6]).
- Regionally, central and southern Africa showed higher stroke DALY rates, northern Africa had the highest rates for ischaemic heart disease, and central and northern Africa had the highest rates for dementia.
- Among 12 modifiable risk factors, high systolic blood pressure, unhealthy diet, and air pollution contributed most to DALYs.
Why it matters
This analysis of Global Burden of Disease data shows dementia burden in Africa is the lowest among five continents by age-standardised rate, while stroke and ischemic heart disease rates are the highest, with cases doubling from 1990 to 2021. It calls for targeted strategies to protect brain health in Africa given limited health resources.
Study details
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Lancet Global Health) |
| Journal's citation record | 2 / 4 | The Lancet Global Health: journal h-index 219 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Alfred Kongnyu NJAMNSHI: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | McGill University: institution h-index 1,373 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40580987) |
| Free to read | 2 / 2 | Free to read |
| Total | 40 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/s2214-109x(25)00109-3
- PubMed: 40580987
- Original source →
- Free full text: The Lancet Global Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Avan, A., Hachinski, V., Njamnshi, W. Y., Andersson, N., & NJAMNSHI, A. K. (2025). The burden of stroke, ischaemic heart disease, and dementia in Africa, 1990–2021: an ecological analysis of the Global Burden of Disease 2021. The Lancet Global Health. https://doi.org/10.1016/s2214-109x(25)00109-3
Vancouver
Avan A, Hachinski V, Njamnshi WY, Andersson N, NJAMNSHI AK. The burden of stroke, ischaemic heart disease, and dementia in Africa, 1990–2021: an ecological analysis of the Global Burden of Disease 2021. The Lancet Global Health. 2025. doi:10.1016/s2214-109x(25)00109-3. PMID: 40580987.
BibTeX
@article{avan2025-40580987,
author = {Avan, Abolfazl and Hachinski, Vladimir and Njamnshi, Wepnyu Yembe and Andersson, Neil and NJAMNSHI, Alfred Kongnyu},
title = {{The burden of stroke, ischaemic heart disease, and dementia in Africa, 1990–2021: an ecological analysis of the Global Burden of Disease 2021}},
journal = {The Lancet Global Health},
year = {2025},
doi = {10.1016/s2214-109x(25)00109-3},
pmid = {40580987},
url = {https://doi.org/10.1016/s2214-109x(25)00109-3}
}
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