Trends in Incidence and Mortality of Stroke in China From 1990 to 2019

Area of Science:

• Epidemiology
• Public Health
• Neurology

Background:

• Stroke represents a major global cause of mortality and morbidity.
• Understanding long-term trends in stroke incidence and mortality is crucial for public health planning.
• China has experienced significant demographic and epidemiological transitions over the past three decades.

Purpose of the Study:

• To analyze the burden and 30-year trends of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in China.
• To identify changes in incidence and mortality rates and absolute numbers from 1990 to 2019.
• To investigate sex-specific incidence trends for ischemic stroke.

Main Methods:

• Utilized data from the Global Burden of Disease (GBD) study 2019 for stroke incidence and mortality in China (1990-2019).
• Analyzed absolute numbers of incident cases and deaths.
• Calculated age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) per 100,000 population.

Main Results:

• In 2019, China recorded 3.9 million incident stroke cases and 2.1 million deaths.
• From 1990 to 2019, the ASIR of ischemic stroke increased by 35.0%, while ICH and SAH ASIR decreased by 53.0% and 39.0%, respectively.
• The ASMR of ischemic stroke showed a slight increase (3.0%), whereas ICH and SAH ASMR decreased significantly (-48.0% and -84.0%, respectively). Ischemic stroke incidence was higher in women.

Conclusions:

• Despite decreasing age-standardized rates, the absolute number of stroke cases and deaths in China nearly doubled between 1990 and 2019.
• A notable increase in the incidence rate of ischemic stroke, particularly among women, requires targeted public health interventions.
• The diverging trends between ischemic stroke and hemorrhagic strokes highlight the need for tailored prevention and management strategies.