Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410006.
School of Medicine, Hunan Normal University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Aug 28;48(8):1217-1224. doi: 10.11817/j.issn.1672-7347.2023.220561.
Stroke has become the leading cause of death and disability among adults in China. This study aims to analyze the disease burden based on gender and age and the risk factors for stroke subtypes in China 2019, and to provide reference for targeted stroke prevention and control.
Based on 2019 data of the Global Burden of Disease (GBD), the gender and age in patients with different stroke subtypes (ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage) in China 2019 was described by using disability-adjusted life years (DALY), and attributable burden of related risk factors was analyzed.
In 2019, the burden of intracranial hemorrhage was the heaviest one in China, resulting in 22.210 6 million person years of DALY, following by ischemic stroke and subarachnoid hemorrhage, resulting in 21.393 9 and 2.344 7 million person years of DALY, respectively. Among them, except the 0-14 age group, the disease burden of different subtypes of stroke in men was higher than that in women. The disease burden of ischemic stroke was increased with age in both men and women, with the heaviest disease burden in ≥70 years group. The disease burden of intracranial hemorrhage and subarachnoid hemorrhage was the heaviest in males aged 50-69 years old, and in females aged ≥70 years and 50-69 years, respectively. Metabolic factors were the main risk factors in all ages of different stroke subtypes, and the most important risk factor was high systolic blood pressure. Other risk factors were different between men and women. Smoking, high body mass index, high low-density lipoprotein, and outdoor particulate matter pollution were the main risk factors for stroke in men, while high body mass index, outdoor particulate matter pollution, and high fasting blood glucose were the main risk factors of stroke in women. The main risk were different among different age groups.
The burden and attributable risk factors for different stroke subtypes are discrepancy in different gender and age groups. Targeted interventions should be conducted in the future to reduce the burden of stroke.
脑卒中已成为中国成年人的首要死因和致残原因。本研究旨在分析 2019 年中国不同性别和年龄组人群脑卒中疾病负担及亚型的危险因素，为针对性的脑卒中防治提供参考。
基于 2019 年全球疾病负担（GBD）研究数据，描述 2019 年中国不同性别和年龄组（缺血性脑卒中、颅内出血、蛛网膜下腔出血）脑卒中患者的残疾调整生命年（DALY），分析相关危险因素的归因负担。
2019 年中国颅内出血负担最重，造成 22.210 6 万 DALY，其次是缺血性脑卒中及蛛网膜下腔出血，造成 21.393 9 及 2.344 7 万 DALY。除 014 岁年龄组外，男性不同亚型脑卒中的疾病负担均高于女性。男性和女性的缺血性脑卒中疾病负担随年龄增长而增加，≥70 岁年龄组疾病负担最重。颅内出血和蛛网膜下腔出血疾病负担在 5069 岁年龄组男性及≥70 岁和 50~69 岁年龄组女性中最重。代谢因素是各年龄组不同脑卒中亚型的主要危险因素，最重要的危险因素是收缩压升高。其他危险因素在不同性别间存在差异。吸烟、高体质指数、高低密度脂蛋白、户外颗粒物污染是男性脑卒中的主要危险因素，而高体质指数、户外颗粒物污染、高空腹血糖是女性脑卒中的主要危险因素。不同年龄组的主要危险因素也不同。
不同性别和年龄组人群脑卒中亚型的疾病负担和可归因危险因素存在差异。未来应采取有针对性的干预措施，降低脑卒中负担。
