The burden of subarachnoid hemorrhage in South Asia has increased substantially between 2000 and 2023, with rising age-standardized rates and a marked growth in absolute deaths and DALYs, particularly in India and Pakistan, while females continue to experience higher mortality rates than males.
Age-standardized SAH mortality rates in South Asia increased by 29.5% from 2000 to 2023.
India recorded the highest age-standardized mortality rate and absolute deaths attributable to SAH among South Asian countries.
DALY rates attributable to SAH increased by 23.9% across South Asia from 2000 to 2023.
India and Pakistan experienced the most significant increases in absolute DALYs attributable to SAH.
Females experienced higher SAH-related mortality rates than males throughout the study period, though the gender disparity narrowed over time.
Key risk factors contributing to SAH mortality in South Asia were identified as hypertension, smoking, household air pollution due to solid fuel use, and body mass index.
The study covered five South Asian countries — India, Pakistan, Bangladesh, Nepal, and Bhutan — using GBD data spanning 2000 to 2023.
This research suggests that subarachnoid hemorrhage (SAH) — a type of serious bleeding stroke that occurs around the brain — has become a significantly larger health problem across South Asia over the past two decades. Using data from the Global Burden of Disease database covering India, Pakistan, Bangladesh, Nepal, and Bhutan from 2000 to 2023, the study found that age-standardized mortality rates rose by nearly 30%, and the total number of deaths more than doubled from about 27,000 to over 65,000 annually. India and Pakistan drove the largest increases, while Bangladesh was an exception, showing a slight decline in rates. The study also found that the overall disease burden — measured in disability-adjusted life years (DALYs), which capture both deaths and years lived with disability — increased by nearly 24% over the same period. Women consistently had higher SAH mortality rates than men throughout the study, though this gender gap narrowed over time. The main risk factors identified as contributing to this burden were high blood pressure, smoking, household air pollution from burning solid fuels, and high body mass index — all of which are potentially preventable or manageable. This research suggests that the growing and aging populations of South Asia, combined with persistent risk factors like hypertension and indoor air pollution, are driving a substantial rise in SAH-related deaths and disability. The findings point to a need for stronger public health programs targeting these specific risk factors in the region, particularly in India and Pakistan where the absolute burden is highest. Addressing these modifiable risk factors could potentially reduce the number of people dying or becoming disabled from this type of stroke.
Raheem A, Waheed S, Muneer K, Khan M, Shamim M, Janjua T, et al.. (2026). Trends in mortality and disability-adjusted life years (DALYs) attributable to subarachnoid hemorrhage in South Asia (2000-2023).. Neurosurgical review. https://doi.org/10.1007/s10143-026-04357-z