Changing trends of disease burden of stroke from 1990 to 2019 and its predictions among the Chinese population

Dong Liang; Qing Guan; Minqing Huang; Yiyu He; Yangjiang Ou; Min Chen; Xiaoxin Zheng; Xiuquan Lin

doi:10.3389/fneur.2023.1255524

Changing trends of disease burden of stroke from 1990 to 2019 and its predictions among the Chinese population

Front Neurol. 2023 Oct 4:14:1255524. doi: 10.3389/fneur.2023.1255524. eCollection 2023.

Authors

Dong Liang^#^{1

2}, Qing Guan^#¹, Minqing Huang^#², Yiyu He^{3

4

5}, Yangjiang Ou⁶, Min Chen¹, Xiaoxin Zheng^{3

4

5}, Xiuquan Lin^{7

2}

Affiliations

¹ The School of Health Management, Fujian Medical University, Fuzhou, Fujian, China.
² The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.
³ Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
⁴ Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, China.
⁵ Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China.
⁶ "The 14th Five-Year Plan" Application Characteristic Discipline of Hunan Province (Clinical Medicine), Hunan Provincial Key Laboratory of the Traditional Chinese Medicine Agricultural Biogenomics, Changsha Medical University, Changsha, Hunan, China.
⁷ Department for Chronic and Noncommunicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China.

^# Contributed equally.

Abstract

Objective: This study aimed to understand the temporal trends in the disease burden of stroke and its attributable risk factors in China, along with the future trends in the next 25 years, that is important for effective prevention strategies and improvement, and to provide new insights into the age- and sex-specific incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and their trends from 1990 to 2019, and the prediction in the next 25 years.

Methods: The Global Burden of Disease Study (2019) was used to extract the data on age- and sex-specific incidence, mortality, and disability-adjusted life-years (DALYs) of stroke in China, 1990-2019. We estimated the estimated annual percentage change (EAPC) to access the temporal trends of the disease burden of stroke. The R package called Nordpred was used to perform an age-period-cohort analysis to predict the prevalence of stroke.

Results: The number of incidence cases, deaths, and DALYs of stroke increased from 1990 to 2019. Overall downward trends were observed in the age-standardized incidence rate (ASIR) from 1990 to 2019. Significant temporal trends in mortality and DALYs of stroke were observed. High systolic blood pressure, smoking, and high-sodium diet were the main driving forces for stroke. The DALYs lost attributable to smoking were different for male and female patients. In the next 25 years, the number of new cases and deaths from stroke should continue to increase. The ASIR and age-standardized mortality rate (ASMR) should show a downward trend among male and female patients.

Conclusion: Despite the overall rates of stroke declined over the period from 1990 to 2019, the absolute number of people affected by stroke has substantially increased. There has been a substantial increase in the burden of stroke due to risk factors and will continue to increase in the next 25 years.

Keywords: disease burden; prediction; risk factor; stroke; temporal trend.

Grants and funding

This study was supported by the National Natural Science Foundation of China (grant numbers 81800431 and 81800444), Fujian Provincial Natural Science Foundation (no. 2018J01121), Fujian Provincial Health Technology Project (no. 2020GGA026), the Natural Science Foundation of Hubei Province (grant number 2018CFB415), the Medical humanities research project of Fujian Medical University (grant number RW202206), and the Fujian Province civil policy theory research topic (grant number FMZD202303).