Estimation of potential health gains from reducing multiple risk factors of stroke in Korea

Objective: To estimate the burden of diseases caused by stroke using disability-adjusted life years (DALY), and to compare the attributable burdens of risk factors with the avoidable burdens. Methods: First, we estimated the disease burden of stroke due to premature death and disability using 2001 morbidity and mortality data in Korea. Second, we selected risk factors and exposure variables of stroke, and decided, via systematic review, on the prevalence and relative risks of these risk factors. Third, we calculated the attributable burdens of stroke in relation to the current prevalence of risk factors, and calculated the avoidable burden of stroke in relation to the counterfactual prevalence of risk factors. Results: The burden of stroke per 100 000 people was determined to be 3394.9 person-years for males, and 2532.2 person-years for females. The burden of stroke at its current prevalence for males per 100 000 people was attributed primarily to smoking (1940.4 person-years), alcohol (864.3 person-years), and hypertension (667.3 person-years). The burden of stroke at its current prevalence for females per 100 000 people was attributed primarily to alcohol (462.8 person-years), physical inactivity (455.7 person-years), and smoking (407.7 person-years). The joint population attributable fraction (PAF) to risk factors was determined to be 80.2% for males, and 52.4% for females. Conclusions: The modification of risk factors constitutes a crucial component of any serious effort to reduce the burden of stroke. In order to reduce the burden of stroke, a health policy in regard to risk factors is clearly required.