Wang Jinghua, Bai Lingling, Shi Min, Yang Li, An Zhongping, Li Bin, Zhao Wenjuan, Gu Hongfei, Zhan Changqing, Tu Jun, Ning Xianjia
From the Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China (J.W., L.B., M.S., J.T., X.N.); Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China (J.W., L.B., M.S., L.Y., J.T., X.N.); Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China (Z.A., W.Z.); Department of Neurology, Tianjin Haibin People's Hospital, Tianjin, China (B.L., H.G.); and Department of Neurology, Wuhu No. 2 People's Hospital, Wuhu, Anhui Province, China (C.Z.).
Stroke. 2016 Apr;47(4):929-35. doi: 10.1161/STROKEAHA.115.012466. Epub 2016 Feb 11.
We investigated secular trends in the age of stroke onset and stroke incidence in a low-income population in rural China.
The study population was recruited from a population-based stroke surveillance study conducted in a township in Tianjin, China, from 1992 to 2014. The trends in mean age and incidence of first-ever stroke were assessed by sex and stroke subtype. Risk factor surveys were conducted in the same population in both 1991 and 2011.
A total of 1053 patients experienced first-ever stroke from 1992 to 2014. The mean age of stroke onset in men significantly decreased by 0.28 years annually overall, by 0.56 years for intracerebral hemorrhage, and by 0.22 years for ischemic stroke (P<0.05). However, a similar trend was not observed in women. The age-standardized first-ever stroke incidence in the same population significantly increased across sex and stroke subtypes, increased by 6.3% overall, 5.5% for men, 7.9% for women, 4.6% for intracerebral hemorrhage, and 7.3% for ischemic stroke (P<0.05) during 1992 to 2014. Concurrently, the prevalence of hypertension, diabetes mellitus, obesity, current smoking, and alcohol consumption increased significantly in young and middle-aged adults from 1991 to 2011.
The age of stroke onset tends to be younger among low-income population in China after the dramatic increased incidence of stroke during the gradual extension of life expectancy of population in China. These findings suggested that stroke burden will continue to increase in the long time, unless the risk factors in low-income populations are effectively controlled.
我们调查了中国农村低收入人群中卒中发病年龄和卒中发病率的长期趋势。
研究人群来自于1992年至2014年在中国天津市一个乡镇开展的基于人群的卒中监测研究。首次卒中的平均年龄和发病率趋势按性别和卒中亚型进行评估。1991年和2011年在同一人群中进行了危险因素调查。
1992年至2014年共有1053例患者首次发生卒中。总体而言,男性卒中发病的平均年龄每年显著下降0.28岁,脑出血患者下降0.56岁,缺血性卒中患者下降0.22岁(P<0.05)。然而,女性未观察到类似趋势。同一人群中年龄标准化的首次卒中发病率在性别和卒中亚型中均显著增加,1992年至2014年期间总体增加6.3%,男性增加5.5%,女性增加7.9%,脑出血增加4.6%,缺血性卒中增加7.3%(P<0.05)。同时,1991年至2011年,中青年成年人中高血压、糖尿病、肥胖、当前吸烟和饮酒的患病率显著增加。
在中国人口预期寿命逐渐延长、卒中发病率急剧上升之后,中国低收入人群的卒中发病年龄趋于年轻化。这些发现表明,除非有效控制低收入人群的危险因素,否则卒中负担在长期内将持续增加。