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Peer-reviewedCC BY-NCAnnals of medicine

Divergent epidemiologic, shared risks: a comparative global analysis of COPD, ischemic stroke, and intracerebral hemorrhage.

  • Bei Chen1
  • Zi Liao1
  • Cunming Lv2,3
  • Lan Yang1
  • Feiyue Sun1
  • Zhigang Mei1,4
4 affiliations
  1. 1Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, Hunan University of Chinese Medicine, Changsha, China.
  2. 2Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, College of Medicine and Health Science, China Three Gorges University, Yichang, China.
  3. 3PKU-IDG/McGovern Institute for Brain Research, National Health and Family Planning Commission, Peking University, Peking, China.
  4. 4Academy of Chinese Medical Sciences, Hunan University of Chinese Medicine, Changsha, China.
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Abstract

Background

Although COPD and stroke share pathological mechanisms and risk factors, their epidemiological patterns differ significantly. This study investigates the global burden of COPD and stroke, analyzing their shared risk factors and epidemiological disparities to inform targeted prevention strategies.Methods

Using Global Burden of Disease (GBD) 2021 estimates, we conducted a repeated cross-sectional comparison of COPD, IS, and ICH from 1990 to 2021. Historical age-standardized rates were taken directly from archived GBD records labelled 'Age-standardized', whereas age-specific analyses used groups aged ≥20 years. We examined temporal, geographical, age-specific, sex-specific, and Socio-demographic Index (SDI) patterns, shared risk-attributable DALY rates, and exploratory Bayesian age-period-cohort (BAPC) projections through 2050.Results

From 1990 to 2021, absolute incident cases for all three conditions increased, while age-standardized incidence rates declined. In 2021, COPD had the highest global ASIR, ASMR, and ASDR among the three diseases. Country-level first-place counts differed by metric: COPD had the highest ASIR in 187 countries and territories, IS the highest ASMR in 110, and ICH the highest ASDR in 95. Air pollution accounted for the largest global attributable DALY burden among the shared Level 2 categories, whereas tobacco predominated in high-SDI settings. Exploratory BAPC projections suggested continued ASDR declines through 2050, with IS potentially having the highest projected ASDR, while age-specific burden increasingly shifted toward older populations.Conclusion

Prevention priorities should reflect disease burden and local resources, with sustained attention to tobacco exposure and air pollution. The observed geographical overlap supports population-level planning and motivates individual-level research, but it does not establish COPD-stroke comorbidity, causality, or clinical predictive value.

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Cite

BibTeXRIS
BibTeX
@article{chen2026divergent,
  title = {{Divergent epidemiologic, shared risks: a comparative global analysis of COPD, ischemic stroke, and intracerebral hemorrhage.}},
  author = {Bei Chen and Zi Liao and Cunming Lv and Lan Yang and Feiyue Sun and Zhigang Mei},
  journal = {Annals of medicine},
  year = {2026},
  month = oct,
  doi = {10.1080/07853890.2026.2750579},
  url = {https://europepmc.org/article/MED/42954075},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Divergent epidemiologic, shared risks: a comparative global analysis of COPD, ischemic stroke, and intracerebral hemorrhage.
AU  - Bei Chen
AU  - Zi Liao
AU  - Cunming Lv
AU  - Lan Yang
AU  - Feiyue Sun
AU  - Zhigang Mei
PY  - 2026
DA  - 2026/10/29
JO  - Annals of medicine
DO  - 10.1080/07853890.2026.2750579
UR  - https://europepmc.org/article/MED/42954075
AB  - Background  Although COPD and stroke share pathological mechanisms and risk factors, their epidemiological patterns differ significantly. This study investigates the global burden of COPD and stroke, analyzing their shared risk factors and epidemiological disparities to inform targeted prevention strategies.Methods  Using Global Burden of Disease (GBD) 2021 estimates, we conducted a repeated cross-sectional comparison of COPD, IS, and ICH from 1990 to 2021. Historical age-standardized rates were taken directly from archived GBD records labelled 'Age-standardized', whereas age-specific analyses used groups aged ≥20 years. We examined temporal, geographical, age-specific, sex-specific, and Socio-demographic Index (SDI) patterns, shared risk-attributable DALY rates, and exploratory Bayesian age-period-cohort (BAPC) projections through 2050.Results  From 1990 to 2021, absolute incident cases for all three conditions increased, while age-standardized incidence rates declined. In 2021, COPD had the highest global ASIR, ASMR, and ASDR among the three diseases. Country-level first-place counts differed by metric: COPD had the highest ASIR in 187 countries and territories, IS the highest ASMR in 110, and ICH the highest ASDR in 95. Air pollution accounted for the largest global attributable DALY burden among the shared Level 2 categories, whereas tobacco predominated in high-SDI settings. Exploratory BAPC projections suggested continued ASDR declines through 2050, with IS potentially having the highest projected ASDR, while age-specific burden increasingly shifted toward older populations.Conclusion  Prevention priorities should reflect disease burden and local resources, with sustained attention to tobacco exposure and air pollution. The observed geographical overlap supports population-level planning and motivates individual-level research, but it does not establish COPD-stroke comorbidity, causality, or clinical predictive value.
SN  - 0785-3890
SN  - 1365-2060
ER  -