Epidemiological transition of stroke in China - Twenty-one-year observational study from the Sino-MONICA-Beijing project

Background and Purpose-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.