UK Stroke Forum 2025 | The causal pathways of socioeconomic inequalities in stroke: a systematic review

So for answering this question, we did a systematic review. In the systematic review, we analyzed three databases and we identified all the papers that were using causal methods to identify the pathway between socioeconomic inequalities and risk, disability, and mortality after stroke. And we found out in 19 studies that the main drivers of stroke risk, drivers of the socioeconomic inequalities in stroke risk, were hypertension and diabetes, which showed the strongest causal pathway, and smoking was also there but the evidence was low; however, it is worth mentioning. And for disability and mortality, the main driver was severity of stroke at three months, and in the longer term, where the unmanaged cardiovascular risk factors, and again hypertension and diabetes. And I think what we can do is to effectively target these cardiovascular risk factors in the most risky populations, in the populations that are most at risk, actually, so it would be creating targeted interventions that effectively address the inequality in managing hypertension and diabetes, these in a clinical setting, but it also requires policy that makes access to high-quality food, and also green spaces, and for example, restricting the sodium that’s allowed to be in the ultra-processed packages, so we can actually impact the populations and not just the individual people and create a fairer profile for stroke risk and outcomes.

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