Co-occurrence patterns and modifiable risk factors of intracerebral hemorrhage and hypertensive heart disease in adults aged 35 and older: a cross-sectional spatial analysis

Global burden analysis revealed significant disparities, with low-SDI regions bearing a disproportionately higher burden. Classification based on DALYs identified 37 countries as ICH-dominant, 30 as HHD-dominant, and 137 as consistent. ASPR-based classification yielded 46 ICH-dominant, 50 HHD-dominant, and 108 consistent countries, indicating a metric-dependent divergence. Risk factor analysis identified four key drivers for DALYs: iron deficiency, high-sodium diet, low calcium diet, and low polyunsaturated fatty acids intake. For ASPR, low bone mineral density was a shared factor for both diseases, while iron deficiency was specific to ICH. The sequential PAF of these risk factors accounted for 77.64% of global ICH DALYs and 29.87% of HHD DALYs, and 28.85% of ICH ASPR and 7.66% of HHD ASPR. The weighted composite risk index further confirmed substantial geographical heterogeneity in the co-burden.