Asia Health Policy Program, Stanford University, Stanford, CA, USA.
First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Stroke. 2020 Jan;15(1):18-28. doi: 10.1177/1747493019873562. Epub 2019 Sep 22.
Stroke is the leading cause of death and years of life lost in China, and this problem is growing because stroke risk factors such as hypertension and hypercholesteremia have been on the rise as China experiences the demographic transition. The Chinese government has created public health initiatives in the form of guidelines, policies and programs to combat this problem, but the dissemination and effectiveness of these policies are not well known.
The aim of this study was to determine trends in stroke incidence, prevalence, and stroke-related mortality in China and to report these trends in the context of stroke initiatives that have been enacted by the Chinese government.
We systematically reviewed articles on stroke rates and stroke initiatives from 1980 to 2017. A meta-regression including 11 studies showed that stroke incidence remained stable at 128.3 per 100,000 per year from 1980 to 2005 and has increased by 21.3 per 100,000 per year since then to 298.7 per 100,000 per year in 2013. A meta-regression including seven studies demonstrated a gradual decline in stroke-related mortality by 6.5 per 100,000 per year since 1980 (a decline from 369.2 in 1980 to 154.7 per 100,000 per year in 2013). Average stroke prevalence was 898.4 per 100,000 over the entire time-period. Limitations included heterogeneity between the studies. We identified 12 stroke initiatives, the first of which was enacted in 2006.
Despite numerous public health initiatives aimed at combating stroke that started in 2006, stroke incidence in China has increased over the last decade, likely as a result of aging and urbanization of the Chinese population.
在中国，中风是导致死亡和丧失生命年数的主要原因，由于高血压和高胆固醇血症等中风危险因素的增加，中国正经历人口转型，这一问题日益严重。中国政府已经制定了公共卫生计划，以指南、政策和项目的形式来应对这一问题，但这些政策的传播和有效性并不为人所知。
本研究旨在确定中国中风发病率、患病率和中风相关死亡率的趋势，并在报告这些趋势时结合中国政府实施的中风计划。
我们系统地回顾了 1980 年至 2017 年有关中风发病率和中风计划的文章。包括 11 项研究的荟萃回归显示，1980 年至 2005 年中风发病率每年稳定在 128.3/10 万人，此后每年增加 21.3/10 万人，至 2013 年达到 298.7/10 万人。包括 7 项研究的荟萃回归表明，自 1980 年以来，中风相关死亡率每年逐渐下降 6.5/10 万人（从 1980 年的 369.2/10 万人下降到 2013 年的 154.7/10 万人）。整个时期的平均中风患病率为 898.4/10 万人。研究之间存在异质性。我们确定了 12 项中风计划，其中第一项于 2006 年实施。
尽管 2006 年开始实施了多项旨在防治中风的公共卫生计划，但中国的中风发病率在过去十年中有所增加，这可能是由于中国人口的老龄化和城市化。
