title: Incidence and trends of stroke and its subtypes in China: results from three large cities.
abstract: OBJECTIVE
  To examine the incidence and trends of stroke and its major subtypes during the 1990s in 3 cities in China.
  
  
  METHODS
  Stroke cases registered between 1991 to 2000 were initially identified through the stroke surveillance networks established in Beijing, Shanghai, and Changsha, and then confirmed by neurologists.
  
  
  RESULTS
  The age-standardized incidence rates per 100,000 person years of overall first-ever stroke were 135.0 (95% CI, 126.5 to 144.6) in Beijing, 76.1 (70.6 to 82.6) in Shanghai, and 150.0 (141.3 to 160.0) in Changsha during the 1990s. Incidence of ischemic stroke (IS) was highest in Beijing, followed by Changsha and Shanghai; for intracerebral hemorrhage (ICH), the highest rate was found in Changsha, followed by Beijing and Shanghai. The same order as ICH was also observed for subarachnoid hemorrhage. The age-adjusted incidence of overall stroke and ICH for individuals > or =55 years of age in our populations was generally higher than that from Western populations. During the 1990s, ICH incidence decreased significantly at a rate of 12.0% per year in Beijing, 4.4% in Shanghai, and 7.7% in Changsha; in contrast, except for Changsha, IS incidence increased in Beijing (5.0% per year) and Shanghai (7.7%).
  
  
  CONCLUSIONS
  There is a geographic variation in the incidence of stroke and its subtypes among these 3 cities, but the incidence of overall and hemorrhagic stroke in China is generally higher than that in the Western countries. Interestingly, the decrease in ICH and increase in IS during the past decade may reflect some underlying changes of risk factors in Chinese populations.
authors.affiliation: Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing 100050, P.R. China. bjyjiang@hotmail.com
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.forename: Wen-zhi
authors.initials: WZ
authors.lastname: Wang
authors.forename: Honglei
authors.initials: H
authors.lastname: Chen
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hong
authors.forename: Qi-dong
authors.initials: QD
authors.lastname: Yang
authors.forename: Sheng-ping
authors.initials: SP
authors.lastname: Wu
authors.forename: Xiao-li
authors.initials: XL
authors.lastname: Du
authors.forename: Qiu-ju
authors.initials: QJ
authors.lastname: Bao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D002681:China; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011786:Quality Control; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D014505:Urban Population