Tianjia Guan1, Jing Ma1, Mei Li1, Tao Xue1, Zongmin Lan1, Jian Guo1, Ying Shen1, Baohua Chao1, Geyuan Tian1, Qiang Zhang1, Longde Wang1, Yuanli Liu2. 1. From the School of Public Health (T.G., J.G., G.T., Y.L.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Brigham & Women's Hospital (J.M.), Harvard Medical School, Boston, MA; National Health and Family Planning Commission of the People's Republic of China (M.L., B.C.); Center for Earth System Science (T.X., Q.Z.), Tsinghua University; Development Research Center of the State Council (Z.L.); Xuanwu Hospital (Y.S.), Capital Medical University; and School of Public Health (L.W.), Peking University Health Science Center, Peking University, Beijing, China. 2. From the School of Public Health (T.G., J.G., G.T., Y.L.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Brigham & Women's Hospital (J.M.), Harvard Medical School, Boston, MA; National Health and Family Planning Commission of the People's Republic of China (M.L., B.C.); Center for Earth System Science (T.X., Q.Z.), Tsinghua University; Development Research Center of the State Council (Z.L.); Xuanwu Hospital (Y.S.), Capital Medical University; and School of Public Health (L.W.), Peking University Health Science Center, Peking University, Beijing, China. yliu_pumc@163.com.
Abstract
OBJECTIVE: To estimate the current prevalence, temporal incidence trends, and contribution of risk factors for stroke in China. METHODS: The China National Stroke Screening Survey (CNSSS) is an ongoing nationwide population-based program. A representative sample of 1,292,010 adults over 40 years old with 31,188 identified stroke cases from the 2013 and 2014 CNSSS database was analyzed to provide descriptive statistics of the prevalence and risk factors for stroke in 2014. In addition, a retrospective evaluation of 12,526 first-ever stroke cases in 2002-2013 and stroke mortality data from the 2002-2013 China Public Health Statistical Yearbook was conducted to estimate the incidence rates. RESULTS: In 2014, the adjusted stroke prevalence was 2.06% in adults aged 40 years and older. After full adjustments, all risk factors assessed showed significant associations with stroke (p < 0.01); the largest contributor was hypertension (population-attributable risk 53.2%), followed by family history, dyslipidemia, atrial fibrillation, diabetes, physical inactivity, smoking, and overweight/obesity. The incidence of first-ever stroke in adults aged 40-74 years increased from 189/100,000 individuals in 2002 to 379/100,000 in 2013-an overall annual increase of 8.3%. Stroke-specific mortality in adults aged 40-74 years has remained stable, at approximately 124 deaths/100,000 individuals in both 2002 and 2013. CONCLUSIONS: In 2002-2013, the incidence of stroke in China increased rapidly. Combined with a high prevalence, a trend toward a younger age, and stable mortality, this finding suggests that additional clinical and behavioral interventions for metabolic and lifestyle risk factors are necessary to prevent stroke, particularly in certain populations.
OBJECTIVE: To estimate the current prevalence, temporal incidence trends, and contribution of risk factors for stroke in China. METHODS: The China National Stroke Screening Survey (CNSSS) is an ongoing nationwide population-based program. A representative sample of 1,292,010 adults over 40 years old with 31,188 identified stroke cases from the 2013 and 2014 CNSSS database was analyzed to provide descriptive statistics of the prevalence and risk factors for stroke in 2014. In addition, a retrospective evaluation of 12,526 first-ever stroke cases in 2002-2013 and stroke mortality data from the 2002-2013 China Public Health Statistical Yearbook was conducted to estimate the incidence rates. RESULTS: In 2014, the adjusted stroke prevalence was 2.06% in adults aged 40 years and older. After full adjustments, all risk factors assessed showed significant associations with stroke (p < 0.01); the largest contributor was hypertension (population-attributable risk 53.2%), followed by family history, dyslipidemia, atrial fibrillation, diabetes, physical inactivity, smoking, and overweight/obesity. The incidence of first-ever stroke in adults aged 40-74 years increased from 189/100,000 individuals in 2002 to 379/100,000 in 2013-an overall annual increase of 8.3%. Stroke-specific mortality in adults aged 40-74 years has remained stable, at approximately 124 deaths/100,000 individuals in both 2002 and 2013. CONCLUSIONS: In 2002-2013, the incidence of stroke in China increased rapidly. Combined with a high prevalence, a trend toward a younger age, and stable mortality, this finding suggests that additional clinical and behavioral interventions for metabolic and lifestyle risk factors are necessary to prevent stroke, particularly in certain populations.