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[The incidence of ischemic and hemorrhagic stroke in Chinese populations]

Lin-feng Zhang1, Jun Yang, Yang-feng Wu

  • 1Department of Epidemiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Zhonghua Nei Ke Za Zhi
|June 5, 2003
PubMed

Insights

Ischemic stroke is predominant in Chinese populations, contrary to previous assumptions. Increased computed tomography (CT) scan rates correlate with a higher ratio of ischemic to hemorrhagic stroke, revealing accurate stroke type incidence.

Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Stroke incidence and classification vary significantly across populations.
  • Accurate stroke subtyping is crucial for effective treatment and public health strategies.
  • Previous studies in Chinese populations suggested a higher incidence of hemorrhagic stroke.

Purpose of the Study:

  • To determine the ratio of ischemic to hemorrhagic stroke incidence in diverse Chinese populations.
  • To investigate the impact of computed tomography (CT) scan rates on stroke classification accuracy.
  • To re-evaluate the predominant stroke type in China.

Main Methods:

  • Prospective monitoring of 150,000 residents across 15 Chinese populations from 1991 to 2000.
  • Stroke classification based on clinical data and CT scan results into hemorrhagic, ischemic, and unclassified categories.
  • Statistical analysis to assess the correlation between CT scan rates and the ischemic to hemorrhagic stroke ratio.

Main Results:

  • The ratio of ischemic to hemorrhagic stroke varied widely (0.23:1 to 4.38:1) across populations.
  • A significant positive correlation (r=0.7, P=0.003) was observed between CT scan rates and the ischemic to hemorrhagic ratio.
  • In populations with CT scan rates >80%, the ischemic to hemorrhagic ratio consistently exceeded 1.0, indicating ischemic stroke predominance.

Conclusions:

  • Ischemic stroke is the predominant type of stroke in the Chinese population.
  • Low CT scan rates in certain regions previously led to an underestimation of ischemic stroke and an overestimation of hemorrhagic stroke.
  • Improving CT scan utilization is essential for accurate stroke epidemiology in China.
Abstract

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