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Mortality from cerebrovascular diseases in China: Exploration of recent and future trends
1Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Insights
Cerebrovascular disease (CVD) mortality in China is decreasing overall but remains high in males, rural areas, and older adults. Projections show increasing CVD deaths, highlighting challenges for prevention and control strategies.
Area of Science:
- Public Health
- Epidemiology
- Gerontology
Background:
- Cerebrovascular disease (CVD) is a leading global cause of death.
- Understanding CVD mortality patterns and trends in China is crucial for public health initiatives.
Purpose of the Study:
- To analyze the mortality patterns of CVD in China in 2020.
- To evaluate the temporal trends of CVD mortality from 2013 to 2019.
- To project future CVD mortality rates up to 2030.
Main Methods:
- Utilized mortality data from the Chinese Center for Disease Control and Prevention's Disease Surveillance Points (CDC-DSP) system.
- Described 2020 CVD mortality by age, sex, residence, and region.
- Applied joinpoint regression for trend analysis (2013-2019) and time series models for future projections.
Main Results:
- In 2019, the age-standardized mortality rate (ASMRC) was 113.2 per 100,000. Higher ASMRC was observed in males, rural areas, and central/western regions.
- Annual ASMRC decreased by 2.43% from 2013-2019, but age-specific mortality increased for those over 85.
- CVD cases and crude mortality rose in 2020; projections indicate 2.3 million deaths by 2025 and 2.4 million by 2030.
Conclusions:
- Targeting CVD prevention and control efforts towards males, rural populations, central/western regions, and individuals aged 75+ is critical.
- Rising mortality in the elderly and increasing future projections present significant challenges for disease management.
- Updated data and analysis are essential for effective public health strategies against cerebrovascular disease in China.
Background:
Cerebrovascular disease (CVD) ranks among the foremost factors responsible for mortality on a global scale. The mortality patterns of CVDs and temporal trends in China need to be well-illustrated and updated.
Methods:
We collected mortality data on patients with CVD from Chinese Center for Disease Control and Prevention's Disease Surveillance Points (CDC-DSP) system. The mortality of CVD in 2020 was described by age, sex, residence, and region. The temporal trend from 2013 to 2019 was evaluated using joinpoint regression, and estimated rates of decline were extrapolated until 2030 using time series models.
Results:
In 2019, the age-standardized mortality in China (ASMRC) per 100,000 individuals was 113.2. The ASMRC for males (137.7/10 5 ) and rural areas (123.0/10 5 ) were both higher when stratified by gender and urban/rural residence. The central region had the highest mortality (126.5/10 5 ), the western region had a slightly lower mortality (123.5/10 5 ), and the eastern region had the lowest mortality (97.3/10 5 ). The age-specific mortality showed an accelerated upward trend from aged 55-59 years, with maximum mortality observed in individuals over 85 years of age. The age-standardized mortality of CVD decreased by 2.43% (95% confidence interval, 1.02-3.81%) annually from 2013 to 2019. Notably, the age-specific mortality of CVD increased from 2013 to 2019 for the age group of over 85 years. In 2020, both the absolute number of CVD cases and the crude mortality of CVD have increased compared to their values in 2019. The estimated total deaths due to CVD were estimated to reach 2.3 million in 2025 and 2.4 million in 2030.
Conclusion:
The heightened focus on the burden of CVD among males, rural areas, the central and western of China, and individuals aged 75 years and above has emerged as a pivotal determinant in further decreasing mortalities, consequently presenting novel challenges to strategies for disease prevention and control.
