Burden and attributable risk factors of ischemic stroke in China from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019

Yang, Yong Sook; Zhu, Yutian; Zhang, Jia-Cheng; Zhang, Haolin; Fan, Rui-Wen; Jin, Y.; Hu, Hang-Qi; Xin, Xiyan; Dong, Lü

doi:10.3389/fneur.2023.1216777

Cited by 3 publications

(4 citation statements)

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“…Between 2013 and 2018, red meat consumption increased among Chinese adults, with the proportion consuming 100 g or more daily increasing by 10%, and male and female proportions of 49.7 and 34.9%, respectively ( 31 ). One study found that the IS disease burden attributed to a diet high in red meat in China is increasing, which may be related to changes in dietary habits among the Chinese population ( 7 ). As China undergoes economic development, dietary and lifestyle changes have increased the population’s exposure to risk factors for IS.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have confirmed that a diet high in red meat is a critical risk factor for IS, leading to a consistent increase in deaths and disability-adjusted life years (DALYs) globally ( 6 ). China has the world’s highest number of IS deaths associated with high red meat intake ( 2 , 7 , 8 ). Nevertheless, the epidemiological features and evolving patterns of IS associated with high red meat consumption in China are not well understood.…”

Section: Introductionmentioning

confidence: 99%

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Burden of ischemic stroke attributable to a high red meat diet in China, 1990–2019: analysis based on the 2019 Global Burden of Disease Study

Jin,

Xia,

Sun

et al. 2024

Front. Nutr.

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BackgroundThe burden of ischemic stroke (IS) linked to high consumption of red meat is on the rise. This study aimed to analyze the mortality and disability-adjusted life years (DALYs) trends for IS attributed to high red meat intake in China between 1990 and 2019 and to compare these trends with global trends.MethodsThis study extracted data on IS attributed to diets high in red meat in China from 1990 to 2019 from the Global Burden of Disease Study (GBD) database. Key measures, including mortality, DALYs, age-standardized mortality rates (ASMR), and age-standardized DALYs rates (ASDR), were used to estimate the disease burden. The estimated annual percentage change and joinpoint regression models were employed to assess the trends over time. An age-period-cohort analysis was used to assess the contribution of a diet high in red meat to the age, period, and cohort effects of IS ASMR and ASDR.ResultsBetween 1990 and 2019, deaths and DALYs from IS attributed to a diet high in red meat in China, along with corresponding age-standardized rates, significantly increased. The overall estimated annual percentage change for the total population and across sex categories ranged from 1.01 to 2.08. The average annual percentage changes for overall ASDR and ASMR were 1.4 and 1.33, respectively, with male ASDR and ASMR average annual percentage changes at 1.69 and 1.69, respectively. Contrastingly, female ASDR and ASMR average annual percentage changes were 1.07 and 0.87, respectively. Except for a few periods of significant decrease in females, all other periods indicated a significant increase or nonsignificant changes. Incidence of IS linked to a diet high in red meat rose sharply with age, displaying increasing period and cohort effects in ASDR. Female ASMR period and cohort effect ratios initially increased and then decreased, whereas the male ratio showed an upward trend.ConclusionThis study comprehensively analyzed epidemiological characteristics that indicated a marked increase in mortality and DALYs from IS attributable to high red meat consumption, contrasting with a global downtrend. This increase was more pronounced in males than females. This research provides valuable insights for enhancing IS prevention in China.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Burden of ischemic stroke attributable to a high red meat diet in China, 1990–2019: analysis based on the 2019 Global Burden of Disease Study

Jin,

Xia,

Sun

et al. 2024

Front. Nutr.

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“…A national platform for remote stroke centers was launched in 2014, and a network is currently being developed to guide timely stroke treatment in rural hospitals 34 . It is encouraging that a low-fiber diet has been declining in recent years 11 , 35 . Compared to GBD 2017, GBD 2019 showed a significant improvement in the proportion of dietary fiber leading to a poor stroke prognosis.…”

Section: Discussionmentioning

confidence: 99%

Disease burden of stroke and its subtypes attributable to low dietary fiber in China, 1990–2019

Jin,

Xie,

Wang

et al. 2024

Sci Rep

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This study aimed to assess the current status and changing trends of the disease burden of stroke and its subtypes due to low dietary fiber intake in China from 1990 to 2019. In cases of stroke and its subtypes attributable to low dietary fiber, deaths, disability-adjusted life-years (DALYs), age-standardized mortality rates (ASMR), age-standardized DALYs rates (ASDR), and percentage change were used to assess disease burden. Data were obtained from the 2019 global burden of disease study. Trends were assessed using Joinpoint regression and age-period-cohort analysis. Between 1990 and 2019, there was a declining trend in stroke and its subtypes, ASDR and ASMR, as well as the corresponding number of deaths and DALYs, due to low dietary fiber intake in China. Subarachnoid hemorrhage (SH) showed the greatest decrease, followed by intracerebral hemorrhage (IH) and ischemic stroke (IS). Local drift curves showed a U-shaped distribution of stroke, IS, and IH DALYs across the whole group and sex-based groups. For mortality, the overall and male trends were similar to those for DALYs, whereas female stroke, IH, and IS showed an upward trend. The DALYs for stroke and IH showed a clear bimodal distribution, IS showed an increasing risk with age. For mortality, the SH subtype showed a decreasing trend, whereas other subtypes showed an increasing risk with age. Both the period and cohort rates of stroke DALYs and motality due to low dietary fiber have declined. Males had a higher risk of DALYs and mortality associated with low fiber levels. The burden of stroke and its subtypes associated with a low-fiber diet in China has been declining over the past 30 years, with different patterns of change for different stroke subtypes and a higher burden for males, highlighting the differential impact of fiber intake on stroke and its subtypes.

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“…Another related study conducted a descriptive analysis of the 30-year trends in incident cases, prevalence, mortality, and DALYs due to IS in China. It also ranked the severity of relevant risk factors in different years [14]. Additionally, clinical trial studies prioritized predictive risk factors for IS in Chinese subjects, revealing that high blood pressure and LDL-C concentration (≤40 mg/dL) are significant predictors of IS risk [15].…”

Section: Introductionmentioning

confidence: 99%

Age-Period-Cohort Analysis of Long-Term Trends in Ischemic Stroke Mortality in China Caused by Specific Risk Factors from 1990 to 2019

Liu,

Sun,

Cheng

et al. 2024

Neuroepidemiology

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Objective: To study the primary risk factors for the long-term trends of mortality rates in ischemic stroke (IS) in China. Methods: Using the Global Burden of Disease Study 2019 (GBD 2019) database, research was conducted on the 11 primary risk factors for the mortality rates of IS in China from 1990 to 2019. This study employed Joinpoint regression software and the Age-Period-Cohort (APC) method to evaluate the trends of mortality rates divided by age, period, and cohort over time. Results: From 1990 to 2019, the age-standardized mortality rate (ASMR) caused by a diet high in red meat and high body-mass index (BMI) in China showed an upward trend. ASMR increased first and then decreased due to smoking, diet high in sodium, particulate matter pollution, high fasting plasma glucose, and high systolic blood pressure. Low-density lipoprotein cholesterol (LDL-C), kidney dysfunction, low temperature, and lead exposure remained relatively stable during this period. In the 35-45 age group, the mortality rate of IS due to high LDL-C was up to about 60%, and smoking affected men more than women. Overall, high LDL-C, high systolic blood pressure, and particulate matter pollution were the most common risk factors in patients with IS. The risk of death rose with age. The period and cohort relative risks showed that metabolic risk factors had the greatest impact on the mortality of IS. Conclusion: Metabolic risk factors have become the primary risk factors for the ASMR of IS in China. Relevant authorities should pay attention to their long-term effects on IS. Effective public health policies and interventions should be implemented to reduce the burden of IS.

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Burden and attributable risk factors of ischemic stroke in China from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019

Cited by 3 publications

References 62 publications

Burden of ischemic stroke attributable to a high red meat diet in China, 1990–2019: analysis based on the 2019 Global Burden of Disease Study

Burden of ischemic stroke attributable to a high red meat diet in China, 1990–2019: analysis based on the 2019 Global Burden of Disease Study

Disease burden of stroke and its subtypes attributable to low dietary fiber in China, 1990–2019

Age-Period-Cohort Analysis of Long-Term Trends in Ischemic Stroke Mortality in China Caused by Specific Risk Factors from 1990 to 2019

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