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(Stroke. 2006;37:63.)
© 2006 American Heart Association, Inc.

Original Contributions

Incidence and Trends of Stroke and Its Subtypes in China

Results From Three Large Cities

Bin Jiang, MD, MPH; Wen-zhi Wang, MD; Honglei Chen, MD, PhD; Zhen Hong, MD; Qi-dong Yang, MD; Sheng-ping Wu, MD; Xiao-li Du, MD Qiu-ju Bao, MD

From the Department of Neuroepidemiology (B.J., W.-Z.W., S.-P.W., X.-L.D., Q.-J.B.), Beijing Neurosurgical Institute, China; Department of Neuroepidemiology (Z.H.), Institute of Neurology, Huashan Hospital, Medical College of Fudan University, Shanghai, China; Department of Neuroepidemiology (Q.-D.Y.), Institute of Neurology, Xiangya Hospital, Medical College of Zhongnan University, Changsha, People’s Republic of China; and Epidemiology Branch, National Institute of Environmental Health Sciences (H.C.), Research Triangle Park, NC.

Correspondence to Bin Jiang, MD, MPH, Department of Neuroepidemiology, Beijing Neurosurgical Institute, 6 Tiantan Xili, Yongnei St, Chongwen District, Beijing 100050, P.R. China. E-mail bjyjiang{at}hotmail.com

Background and Purpose— 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 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.

Key Words: epidemiology • stroke • incidence

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