Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project.
OBJECTIVE
Epidemiological patterns of stroke may change with economic development. It is important to understand these changes for making timely strategies for stroke prevention. The aim of this study was to examine the changes in trends of stroke epidemiology during a period of fast economic development in China, based on data of the Sino-MONICA-Beijing project.


METHODS
Acute stroke events were registered in a large defined population aged 25 through 74 years from 1984 to 2004. The age standardized incidence rates and case fatality rates of total stroke, ischemic stroke and hemorrhagic stroke were calculated. The trends were analyzed by a regression model.


RESULTS
There was a total of 14 584 stroke events registered in the study population from 1984 through 2004. The incidence rate of hemorrhagic stroke declined by 1.7% and the incidence rate of ischemic stroke increased by 8.7% annually on average. The case fatality rates significantly reduced in both types of stroke. The mean onset age of stroke was delayed by 2.7 years in men and 3.6 years in women. The proportion of deaths of cerebrovascular disease out of total deaths decreased and the proportion of ischemic heart disease increased during the study period.


CONCLUSIONS
Characteristics of stroke transition were found during a period of economic development in China. The changes in patterns of stroke have raised new challenges and the need for priority adjustment for stroke prevention in China.
Zhao
Dong
D
Department of Epidemiology, Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung & Blood Vessel Diseases, Anzhenli, Chaoyang District, Beijing 100029, P.R. China. deezhao@anzhen.org
Liu
Jing
J
Wang
Wei
W
Zeng
Zhechun
Z
Cheng
Jun
J
Liu
Jun
J
Sun
Jiayi
J
Wu
Zhaosu
Z
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002545:Brain Ischemia / Q000191:economics / Q000401:mortality* / Q000517:prevention & control; D002543:Cerebral Hemorrhage / Q000191:economics / Q000401:mortality* / Q000517:prevention & control; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity / Q000639:trends; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D040242:Risk Reduction Behavior; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D020521:Stroke / Q000191:economics / Q000401:mortality* / Q000517:prevention & control