Incidence and Trends of Stroke and Its Subtypes in China

Jiang, Bin; Wang, Wenzhi; Chen, Honglei; Hong, Zhen; Yang, Qidong; Wu, Shengping; Du, Xin; Qin, Bangyong

doi:10.1161/01.str.0000194955.34820.78

Cited by 259 publications

(244 citation statements)

References 25 publications

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“…Previous studies have demonstrated that the duration of ischemic stroke is associated with motor function disorders, such as spasticity (21,22). A number of pathological events are associated with brain damage, including ischemic injury-induced neuroinflammation, which leads to tissue damage as indicated by the results of the present study.…”

Section: Discussionsupporting

confidence: 73%

Anti-inflammatory effects of Guolou Guizhi decoction in transient focal cerebral ischemic brains

Lin

Zhu

et al. 2012

Molecular Medicine Reports

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Abstract. The aim of the present study was to explore the neuroprotective effects of Gualou Guizhi decoction (GLGZD) in a rat model of middle cerebral artery occlusion (MCAO). Sprague-Dawley rats were divided into three groups: Sham (no MCAO), MCAO (MCAO with no GLGZD treatment) and GLGZD (MCAO with GLGZD treatment). Rats in the MCAO and GLGZD groups were subjected to permanent occlusion of the left middle cerebral artery. Neurological function and infarct volume were measured. Microglial activation and inflammatory cell accumulation were measured using immunohistochemistry. mRNA and protein expression of inflammatory mediators were examined using reverse transcription-quantitative polymerase chain reaction and an enzyme-linked immunosorbent assay. The expression of proteins associated with the nuclear factor κ-B (NF-κB) inflammation signaling pathway was analyzed using western blotting. The results of the present study suggested that infarct size was significantly reduced and neurological behavior function was improved in rats with MCAO treated with GLGZD compared with rats in the MCAO group. Amoeboid microglial expansion and inflammatory cell migration were observed in the infarcted areas of rats in the GLGZD group and were not identified in those of the MCAO group. Target mRNA and protein levels, and inflammatory cell infiltration were significantly reduced in the GLGZD group compared with the MCAO model group. Notably, GLGZD treatment induced neuroprotective effects, reducing inflammation and inhibiting NF-κB signaling compared with the MCAO group. Therefore, GLGZD may exhibit anti-inflammatory effects against ischemia-reperfusion brain injury and may be a therapeutic target for ischemic stroke. IntroductionStroke is the one of leading causes of morbidity and mortality worldwide (1,2). Ischemic stroke is a sudden interruption of blood supply to the brain caused by the blockage of an artery, which may result in brain damage and neurologic dysfunction (3). The suppression of brain damage resulting from ischemic stroke is essential in order to prevent a decrease in the quality of life for patients. However, a therapeutic strategy for cerebral ischemia/reperfusion injury has yet to be established (4-6). Neuroinflammation following ischemia is characterized by the rapid activation of resident microglia and the infiltration of inflammatory cells. Neuroinflammation causes an increase in the expression of proinflammatory cytokines and reactive oxygen species, and may lead to blood-brain barrier disruption, brain edema, and cell necrosis and apoptosis. Recent studies have demonstrated that reactive microglia express inflammatory mediators that may increase the risk of stroke in patients with permanent middle cerebral artery occlusion (MCAO) and transient ischemia (7-9). The maintenance of microglial function during focal stroke may be more important than that of neurons. The mechanisms of microglial activation involve nuclear factor-κB (NF-κB) and mitogen-activated protein kinases (MAPK) signaling pathways. The infla...

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Section: Discussionsupporting

confidence: 73%

Anti-inflammatory effects of Guolou Guizhi decoction in transient focal cerebral ischemic brains

Lin

Zhu

et al. 2012

Molecular Medicine Reports

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“…Some attention has been paid to the effects of geographical differences on stroke occurrences, with an earlier study by Jiang et al, 21 having found that there were geographical variations in the prevalence of strokes between three major cities in China: Beijing, Shanghai, and Changsha. Engstrom et al 20 had earlier examined 17 areas and found marked differences between stroke prevalence levels within different residential areas.…”

Section: Discussionmentioning

confidence: 99%

“…6,7,[9][10][11][12][13][14][15][16][17][18][19] Very few studies, however, have set out to investigate the prevalence of strokes in terms of geographical distribution. 20,21 Moreover, studies examining the relationship between the prevalence of strokes and the level of urbanization of the community in which strokes are occurring are virtually nonexistent. The absence of such studies is clearly detrimental to the efforts of clinicians and policymakers alike, as this impedes their ability to consider the policy implications of the impacts of urbanization level on stroke prevalence, and thereby, their ability to develop effective strategies aimed at preventing stroke occurrences within certain regions and/or communities.…”

Section: Introductionmentioning

confidence: 99%

Urbanization and Stroke Prevalence in Taiwan: Analysis of a Nationwide Survey

Lin

Lin²,

Liu³

et al. 2007

J Urban Health

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This study aims to explore the prevalence of strokes among individuals and the association with urbanization levels. A total sample of 9,794 individuals was obtained from a nationwide survey on Taiwan for subsequent analysis in this study. After adjusting for gender, age, other risk factors for stroke and individual socioeconomic status, a multivariate logistic regression model was employed to investigate the relationships existing between the prevalence of strokes and the level of urbanization. This study finds that those living in areas at the highest level of urbanization (level 1) had the highest prevalence of strokes (2.49%). With decreasing urbanization level, there was a general decline in stroke prevalence. After adjusting for other factors, the multivariate logistic regression analyses showed that compared to participants living in the highest urbanization level, the respective odds ratios of suffering a stroke for those living in areas at the lowest levels of urbanization (levels 7 and 8), were 0.43 and 0.30. We conclude that after adjusting for other stroke risk factors, the level of urbanization is an important contributory factor to the overall prevalence of strokes in Taiwan.

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“…10,15 Although marked reductions in stroke incidence and fatality have been shown for many decades in Japan, these trends seem to be less consistent in other Asian countries. 18 In China, for instance, it was reported that temporal trends of IS incidence have increased over recent years, 19 whereas trends in Hong Kong Chinese were reported to have decreased. 27 A recent systematic review has confirmed the lack of reliable information regarding temporal trends of stroke in most countries in Southeast Asia, despite the substantial impact these countries have on the global burden from cerebrovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19] In addition, there seems to be a lack of information regarding trends in important population subgroups to identify at-risk populations and estimate the future burden of disease. Finally, there is no data exploring interethnic differences in a multiethnic Asian population.…”

mentioning

confidence: 99%

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population

Tan

Müller‐Riemenschneider

et al. 2015

Stroke

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Background and Purpose-This study investigated trends in stroke incidence and case fatality overall and according to sex, age, ethnicity, and stroke subtype in a multiethnic Asian population. Methods-The Singapore Stroke Registry identifies all stroke cases in all public hospitals using medical claims, hospital discharge summaries, and death registry data. Age-standardized incidence rates and 28-day case-fatality rates were calculated for individuals aged ≥15 years between 2006 and 2012. To estimate the annual percentage change of the rates, a linear regression model was fitted to the log rates, and a Wald test was performed to test for trend. P values <0.05 were considered significant. Results-A total of 40 623 cases were recorded. The total stroke incidence fell by ≈12.0%, and case fatality fell by 17.2% in the study. Declining trends in stroke incidence were stronger in women . Subgroup-specific findings for case fatality were similar. Conclusion-This is the first countrywide hospital-based registry study in a multiethnic Asian population, and it revealed marked overall reductions in stroke incidence and case fatality. However, it also identified important population groups with less favorable trends, especially younger adults and those of Malay ethnicity.

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Incidence and Trends of Stroke and Its Subtypes in China

Cited by 259 publications

References 25 publications

Anti-inflammatory effects of Guolou Guizhi decoction in transient focal cerebral ischemic brains

Anti-inflammatory effects of Guolou Guizhi decoction in transient focal cerebral ischemic brains

Urbanization and Stroke Prevalence in Taiwan: Analysis of a Nationwide Survey

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population

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