This study is probably one of the most important contributions to the field of global stroke epidemiology in the last 30 years.

The work is based on epidemiological reports from 204 countries or territories from 1990 to 2021. The article confirms that stroke remains one of the health problems with the greatest impact on both mortality and dependency worldwide.

The main finding of the study is that, in absolute numbers, the global impact of stroke has increased over the past 30 years. This finding may be due to several reasons: the increase in the world's population; the ageing of the population (especially in rich countries); and the use of inadequate or insufficient prevention strategies, and probably very disparate according to the country (and its economic level).
Another very relevant aspect of the article is the detection of important disparities in the incidence, prevalence, impact and mortality of stroke according to the economic level of the country or geographical area studied. This result is probably related to insufficient prevention strategies in poor countries: poorer control of vascular risk factors such as hypertension and smoking.
The relationship of certain individual habits or lifestyles (consumption of sugary drinks, low physical activity, diet low in polyunsaturated fat, body mass index, etc.) with stroke risk has been identified and confirmed, but also other environmental factors (and therefore not correctable at the individual level) that also increase the risk of stroke. These factors are, for example, high temperatures (heat waves) or air pollution by particulate matter.

A relevant finding of this work is the relationship (detected for the first time) between air pollution by particulate matter and an increased risk of subarachnoid haemorrhage.
The synergistic effect between air pollution, climate change and rising temperatures has been shown to influence the risk of vascular diseases and, in particular, stroke.
The increase in the global health impact of stroke observed in recent years demonstrates that prevention strategies employed so far are insufficient or inadequate and probably need to go beyond lifestyle changes at the individual level. Global policies to combat air pollution and climate change are needed.