Bai Ruhai, Li Minmin, Bhurtyal Ashok, Zhu Wenxuan, Dong Wanyue, Dong Di, Sun Jing, Su Yanfang, Li Yan
School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210094, China.
Clinical Medical Research Center, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
Healthcare (Basel). 2024 Sep 10;12(18):1809. doi: 10.3390/healthcare12181809.
South Asia contributes the most to stroke mortality worldwide. This study aimed to determine the long-term trends in stroke mortality across four South Asian countries and its associations with age, period, and birth cohort. In 2019, nearly one million stroke deaths occurred across South Asia, and the associated age-standardized mortality rate (ASMR) was 80.2 per 100,000. Between 1990 and 2019, India had the largest decrease in the ASMR (-35.8%) across the four South Asian countries. While Pakistan had the smallest decrease in the ASMR (-7.6%), an increase was detected among males aged 15 to 34 years and females aged 15 to 19 years. Despite a 22.8% decrease in the ASMR, Bangladesh had the highest ASMR across the four South Asian countries. Nepal reported a witness increase in the stroke ASMR after 2006. Improved period and cohort effects on stroke mortality were generally indicated across the analyzed countries, except for recent-period effects in males from Nepal and cohort effects from those born after the 1970s in Pakistan. Stroke mortality has decreased in the four South Asian countries over the past 30 years, but potentially unfavorable period and cohort effects have emerged in males in Nepal and both sexes in Pakistan. Governmental and societal efforts are needed to maintain decreasing trends in stroke mortality.
南亚是全球中风死亡率贡献最大的地区。本研究旨在确定四个南亚国家中风死亡率的长期趋势及其与年龄、时期和出生队列的关联。2019年，南亚地区发生了近100万例中风死亡病例，相关的年龄标准化死亡率（ASMR）为每10万人80.2例。1990年至2019年间，在四个南亚国家中，印度的ASMR下降幅度最大（-35.8%）。而巴基斯坦的ASMR下降幅度最小（-7.6%），15至34岁男性和15至19岁女性的ASMR有所上升。尽管ASMR下降了22.8%，但孟加拉国是四个南亚国家中ASMR最高的。尼泊尔报告称，2006年后中风的ASMR出现了明显上升。除了尼泊尔男性的近期效应和巴基斯坦20世纪70年代后出生人群的队列效应外，分析的各个国家总体上显示出中风死亡率的时期和队列效应有所改善。在过去30年中，四个南亚国家的中风死亡率有所下降，但尼泊尔男性和巴基斯坦两性中出现了潜在不利的时期和队列效应。需要政府和社会的努力来维持中风死亡率的下降趋势。
