Changes in the disease burden of ischemic stroke in China from 1990 to 2019_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Le ^1,2 , YU Chao ³ , LIAO Yiwen ¹ , LI Jingjing ¹ , LIU Xingyu ^1,2 ,  KUANG Jie ^1,2

1. Department of Epidemiology, School of Public Health, Nanchang University, Nanchang 330006, P. R. China;
2. Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang 330006, P. R. China;
3. Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China;

Corresponding author：

KUANG Jie, Email: kuangjie@ncu.edu.cn

Keywords：

Ischemic stroke; Disease burden; Incidence; Mortality; Disability-adjusted life year (DALY)

DOI：

10.7507/1672-2531.202205112

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Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. Conclusion The curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.

Citation： LIU Le, YU Chao, LIAO Yiwen, LI Jingjing, LIU Xingyu, KUANG Jie. Changes in the disease burden of ischemic stroke in China from 1990 to 2019. Chinese Journal of Evidence-Based Medicine, 2022, 22(9): 993-998. doi: 10.7507/1672-2531.202205112 Copy

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1. 王陇德, 彭斌, 张鸿祺, 等. 《中国脑卒中防治报告2020》概要. 中国脑血管病杂志, 2022, 19(2): 136-144.
2. 宇传华, 罗丽莎, 李梅, 等. 从全球视角看中国脑卒中疾病负担的严峻性. 公共卫生与预防医学, 2016, 27(1): 1-5.
3. 马林, 巢宝华, 曹雷, 等. 2007—2017年中国脑卒中流行趋势及特征分析. 中华脑血管病杂志(电子版), 2020, 14(5): 253-258.
4. 《中国脑卒中防治报告2018》编写组. 我国脑卒中防治仍面临巨大挑战—《中国脑卒中防治报告2018》概要. 中国循环杂志, 2019, 34(2): 105-119.
5. 亓建羽, 王晨冉, 刘咪, 等. 1990—2017年中国与不同社会人口学指数地区脑卒中疾病负担和危险因素的比较分析. 中华预防医学杂志, 2021, 55(8): 958-964.
6. 刘咪, 王晨冉, 梁娟娟, 等. 中国1990—2017年脑卒中及其危险因素疾病负担变化趋势分析. 中国公共卫生, 2021, 37(10): 1501-1507.
7. 于洗河, 高尚, 贾欢欢, 等. 1999年、2009年、2019年我国与全球脑卒中疾病负担研究. 中国卫生经济, 2021, 40(6): 58-61.
8. 罗丽莎, 宇传华, 孟润堂, 等. 应用伤残调整寿命年分析中国脑卒中疾病负担与危险因素. 中国卫生统计, 2017, 34(4): 542-545.
9. Wang YJ, Li ZX, Gu HQ, et al. China stroke statistics 2019: a report from the National Center for Healthcare Quality Management in Neurological Diseases, China National Clinical Research Center for Neurological Diseases, the Chinese Stroke Association, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention and Institute for Global Neuroscience and Stroke Collaborations. Stroke Vasc Neurol, 2020, 5(3): 211-239.
10. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
11. GBD 2017 Childhood Cancer Collaborators. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol, 2019, 20(9): 1211-1225.
12. Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet, 2016, 387(10015): 251-272.
13. Lopez AD, Mathers CD, Ezzati M, et al. Global burden of disease and risk factors. New York: Oxford University Press, 2006.
14. Roy-O'Reilly M, McCullough LD. Age and sex are critical factors in ischemic stroke pathology. Endocrinology, 2018, 159(8): 3120-3131.
15. Diener HC, Hankey GJ. Primary and secondary prevention of ischemic stroke and cerebral hemorrhage: JACC focus seminar. J Am Coll Cardiol, 2020, 75(15): 1804-1818.
16. 刘明法, 周脉耕, 刘世炜, 等. 1990和2015年天津市脑卒中死亡率和疾病负担分析. 中国现代神经疾病杂志, 2018, 18(7): 520-526.
17. 徐颖, 刘海韵, 于绍轶, 等. 烟台市2015年脑卒中疾病负担分析. 中国慢性病预防与控制, 2017, 25(11): 875-877.
18. 胡永勤. 人口性别和年龄变量对脑卒中发病的影响. 中国慢性病预防与控制, 2012, 20(4): 485-486.
19. Worrall BB, Johnston KC, Kongable G, et al. Stroke risk factor profiles in African American women: an interim report from the African-American antiplatelet stroke prevention study. Stroke, 2002, 33(4): 913-919.
20. 周官恩, 安中平, 王景华, 等. 缺血性脑卒中分型, 危险因素和预后的性别差异研究. 中风与神经疾病杂志, 2014, 31(7): 625-627.
21. 李卫征, 刘鸣, 吴波, 等. 不同性别脑卒中危险因素类型及预后的比较研究. 中国实用内科杂志, 2009, 29(5): 444-446.
22. 王雷, 熊晓星. 年龄和性别因素对缺血性脑卒中的影响研究进展. 国际神经病学神经外科学杂志, 2017, 44(1): 106-109.

Chinese Journal of Evidence-Based Medicine

Changes in the disease burden of ischemic stroke in China from 1990 to 2019

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