School of Public Health, Department of Epidemiology and Health Statistics, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin 300070, China.
Tianjin Bin Hai New Area Center for Diseases Control and Prevention, Department of STD&AIDS Control and Prevention, Bin Hai New Area District, Tianjin, China.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104959. doi: 10.1016/j.jstrokecerebrovasdis.2020.104959. Epub 2020 Jun 2.
The impact of socioeconomic developments on stroke incidence and mortality must be understood to target prevention strategies appropriately. We assessed the secular trends in stroke incidence and mortality in China based on data from the Global Burden of Disease Study 2016.
Trends of stroke incidence and mortality of China was described in different categories of age, sex and stroke type using the GBD study database. Also a comparative study was conducted between China and Japan, U.S. to find reasonable references for development. Secular trends in incidence and mortality (per 100,000 population) were assessed for stroke, including ischemic and hemorrhagic stroke from 1990 to 2016. Population pyramid was used to illustrate changes in age- and sex-specific incidence and mortality rates.
During the study period, stroke incidence in China increased from 204.52 to 403.08 and mortality increased from 122.09 to 130.94; the corresponding age-standardized rates changed from 335.63 to 353.70 and from 231.28 to 132.84, respectively. Among those aged 15-49 and 50-69 years, the incidence rates of ischemic stroke and hemorrhagic stroke both tended to increase, whereas the mortality rates tended to decline in all age groups. The incidence and mortality were highest among those aged ≥70 years. Compared with the U.S. and Japan, age-standardized rates of incidence and mortality were higher in China.
Although the incidence of stroke has increased in China, overall mortality has decreased. A priority of stroke prevention and control strategies will transition from reducing mortality to controlling the incidence in at-risk populations.
为了有针对性地制定预防策略，必须了解社会经济发展对卒中发病率和死亡率的影响。我们根据 2016 年全球疾病负担研究的数据评估了中国卒中发病率和死亡率的变化趋势。
利用 GBD 研究数据库，描述了不同年龄、性别和卒中类型的中国卒中发病率和死亡率的变化趋势。同时，还对中国与日本、美国进行了对比研究，为发展寻找合理的参考。评估了卒中（包括缺血性卒中和出血性卒中）的发病率和死亡率（每 10 万人）的时间趋势，包括 1990 年至 2016 年的变化情况。使用人口金字塔图说明了年龄和性别特异性发病率和死亡率的变化情况。
在研究期间，中国的卒中发病率从 204.52 升至 403.08，死亡率从 122.09 升至 130.94；相应的年龄标准化率从 335.63 升至 353.70，从 231.28 降至 132.84。在 15-49 岁和 50-69 岁人群中，缺血性卒中和出血性卒中的发病率均呈上升趋势，而所有年龄组的死亡率均呈下降趋势。发病率和死亡率最高的是≥70 岁的人群。与美国和日本相比，中国的发病率和死亡率的年龄标准化率更高。
尽管中国的卒中发病率有所上升，但总体死亡率有所下降。卒中预防和控制策略的重点将从降低死亡率转移到控制高危人群的发病率。
