SeriesStroke in China: epidemiology, prevention, and management strategies
Introduction
Stroke is the second commonest cause of death and leading cause of adult disability worldwide.1 Over two-thirds of stroke deaths worldwide are in developing countries.2 Among developing countries, China has the largest population (with one-fifth of the world's population). Chronic diseases now account for an estimated 80% of deaths and 70% of disability-adjusted life-years lost in China. The major causes of death in China are vascular disease, cancer, and chronic respiratory disease.3 Unlike in western countries, cerebrovascular disease predominates; the number of patients who die from stroke is more than three times that from coronary heart disease.4 In the past 20 years, China has experienced a rapid economic development. Over time, the proportion of elderly people in the population will likely increase, life expectancies will lengthen, and, as in some other developing countries, the influence of a westernised lifestyle might shift disease patterns towards a profile more similar to that seen in more developed regions, so that the number of strokes will rise. To provide new insights into the burden and care of stroke in mainland China (not including Hong Kong or Taiwan) and focus future international research and therapeutic efforts, we examined the current status of stroke epidemiology, prevention, and control strategies.
Section snippets
Search strategy and selection criteria
Data were identified by electronic searches of MEDLINE (January 1966 to October 2006), China Biological Medicine Database (CBM-disc 1979 to October 2006), China National Knowledge Infrastructure (CNKI 1996 to October 2006) with the terms “China”, “Chinese”, “epidemiology”, “epidemiological”, “incidence”, “prevalence”, “mortality”, “morbidity”, “fatality”, “case fatality”, “stroke”, “cerebrovascular accident”, “isch(a)emic stroke”, “intracerebral”, “subarachnoid”, “h(a)emorrhage”, “primary
Incidence
Eight studies relevant to stroke incidence were included. The main methodological characteristics and findings of the studies are summarised in table 1. The first multicentre, community-based study on stroke incidence in China was published in 1985.7 Four early studies used similar methods to investigate incidence in various populations.7, 8, 9, 10, 11, 12 The total average age-adjusted incidence of first-ever stroke ranged from 116 to 219 per 100 000 per year. The six-city incidence study7 and
Discussion
In China, epidemiological studies of neurological diseases began in the early 1980s. The most widely cited incidence, mortality, and prevalence data of stroke resulted from two early studies.7, 8, 9 The total incidence of first-ever stroke (115·61–219 per 100 000 per year) was not very different from that in more developed countries (130–410 per 100 000 per year).26 However, more than 20 years have passed and China has changed and developed rapidly during this period, and epidemiological
References (55)
- et al.
The global stroke initiative
Lancet Neurol
(2004) Stroke epidemiology in the developing world
Lancet
(2005)- et al.
Preventing chronic diseases in China
Lancet
(2005) - et al.
How to study stroke incidence
Lancet
(2004) - et al.
Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century
Lancet Neurol
(2003) - et al.
Hospital management of acute ischemic stroke in China
J Stroke Cerebrovasc Dis
(1997) Lack of epidemiological data on secondary stroke prevention
Lancet Neurol
(2005)- et al.
Sino-MONICA project A collaborative study on trends and determinants in cardiovascular diseases in China, part I: morbidity and mortality monitoring
Circulation
(2001) - et al.
Comparing stroke incidence worldwide: what makes studies comparable?
Stroke
(1996) - et al.
Cerebrovascular disease in the People's Republic of China: epidemiologic and clinical features
Neurology
(1985)
Epidemiological survey of neurological disorders in six urban areas of People's Republic of China
Zhong-Hua Shen-Jing Wai-ke Za-Zhi
Epidemiological survey of cerebrovascular disease in rural areas of China
Zhong-Hua Shen-Jing Wai-ke Za-Zhi
Stroke in China, 1986 through 1990
Stroke
Epidemiological survey: stroke in urban and rural areas of China
Chin Med J
Stroke in the People's Republic of China, I: geographic variations in incidence and risk factors
Stroke
Epidemiological characteristics of stroke in 16 provinces of China
Nat Med J Chin
Stroke trends in the WHO MONICA project
Stroke
Incidence and trends of stroke and its subtypes in China: results from three large cities
Stroke
Stroke incidence and survival among middle-aged adults: 9-year follow-up of the atherosclerosis risk in communities (ARIC) cochort
Stroke
Proportion of different subtypes of stroke in China
Stroke
Chinese Health Statistical Digest 2006
Ministry of Health, People's Republic of China
Community comprehensive preventive study on cardial and cerebral vascular diseases
Chin J Prevent Med
Stroke in the People's Republic of China
Stroke
International trends in mortality from stroke, 1968 to 1994
Stroke
Epidemiology of stroke
Lancet
Multinational comparisons of stroke epidemiology: evaluation of case ascertainment in the WHO MONICA stroke study
Stroke
Epidemiology of cerebrovascular diseases
Cited by (718)
The morphology of occlusion stump for endovascular recanalization in non-acute vertebral ostial occlusion
2024, Journal of Clinical NeuroscienceAge and geographic disparities in acute ischaemic stroke prehospital delays in China: a cross-sectional study using national stroke registry data
2023, The Lancet Regional Health - Western PacificPrognostic factors of prolonged disorder of consciousness after stroke: A single centre retrospective study
2023, Journal of NeurorestoratologyBuyang Huanwu decoction alleviates oxidative injury of cerebral ischemia-reperfusion through PKCε/Nrf2 signaling pathway
2023, Journal of EthnopharmacologyProteomics reveals that Di Dang decoction can regulate the Jak2/Stat5 signaling pathway and inhibit apoptosis by reducing the oxidative stress response in rats with acute intracerebral hemorrhagic stroke
2023, Journal of EthnopharmacologyCitation Excerpt :Acute intracerebral hemorrhage (AICH), i.e., refers to nontraumatic intracerebral blood vessel rupture, which causes a substantial amount of blood to accumulate in the brain. Among the different types of stroke, the incidence of AICH is second only to that of bleeding stroke, accounting for approximately 18.8%–47.6% of all stroke cases(Liu et al., 2007; Tsai et al., 2013; van Asch et al., 2010). The basal ganglia is the most common area affected by AICH, as cerebral hemorrhage in this area accounts for 40% of all cerebral hemorrhage cases.