Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013

Guan, Tianjia; Ma, Jing; Li, Mei; Xue, Tao; Lan, Zongmin; Guo, Jian; Shen, Ying; Chao, Baohua; Tian, Geyuan; Zhang, Qiang; Wang, Longde; Liu, Yuanli

doi:10.1212/wnl.0000000000004056

Cited by 176 publications

(196 citation statements)

References 28 publications

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“…Stroke is a leading cause of adult mortality and disability, and there are approximately 3 million new stroke cases every year in China [1,2]. In the past several decades, the incidence of stroke has decreased because of effective strategies for preventing cerebrovascular risk factor and good health services in developed countries.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of stroke and stroke related risk factors: a population based cross sectional survey in southwestern China

Luo

Zhou

et al. 2020

BMC Neurol

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Background: Stroke and its risk factors epidemiological survey can help identify individuals at higher risk and therefore promote stroke prevention strategies. The aim of this study was to estimate the current prevalence of stroke and high risk stroke population, and evaluate stroke associated risk factors in southwestern China. Methods: This was a multi-center, cross sectional survey in southwestern China from May 2015 to September 2015. The eight communities were selected at random, and 17,413 residents aged ≥40 years volunteered to participate in this survey. Data were collected through face-to-face survey using a structured questionnaire. Five hundred twentyone participants with incomplete questionnaires on stroke history or risk factors records were excluded. Results: A total of 16,892 people included in analysis. The overall prevalence of stroke was 3.1% (95% CI 2.6-3.9%), 17.1% of participants were the high risk stroke population. After full adjustments, hypertension, diabetes, dyslipidemia, overweight, lack of exercise and family history of stroke were significantly associated with overall stroke and ischemic stroke. The largest contributor was hypertension (population-attributable risk 23.6%), followed by dyslipidemia, physical inactivity, family history of stroke, diabetes, and overweight. However, only hypertension (OR = 3.66, 95% CI 1.82-8.23) was significantly associated with hemorrhagic stroke. Conclusions: The prevalence of stroke and high risk stroke population was high among adults aged ≥40 years in southwestern China. Hypertension, dyslipidemia and lack of exercise were stronger contributors for stroke, these findings suggest that individual-level and population-level interventions for these leading risk factors are necessary to prevent stroke.

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Section: Introductionmentioning

confidence: 99%

Prevalence of stroke and stroke related risk factors: a population based cross sectional survey in southwestern China

Luo

Zhou

et al. 2020

BMC Neurol

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“…Stroke is a major cause of death and adult disability (Luengo-Fernandez et al, 2013), and there are approximately 3-4 million new stroke cases every year in China, with roughly 80% being ischemic strokes (IS) (Guan et al, 2017;Jiang et al, 2006;Wang et al, 2007).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Stroke is a major cause of death and adult disability (Luengo‐Fernandez et al, ), and there are approximately 3–4 million new stroke cases every year in China, with roughly 80% being ischemic strokes (IS) (Guan et al, ; Jiang et al, ; Wang et al, ). Atrial fibrillation (AF) is an independent risk factor for IS, and accounts for 10%–25% of all ischemic strokes (Meschia et al, ; Sposato et al, ).…”

Section: Introductionmentioning

confidence: 99%

Matrix metalloproteinase‐9 gene polymorphisms are associated with ischemic stroke severity and early neurologic deterioration in patients with atrial fibrillation

Zhou

Sui³

et al. 2019

Brain and Behavior

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Objectives The mechanisms of ischemic stroke severity and early neurologic deterioration (END) are not fully understood. The aim of the present study was to investigate the association of six variants in MMP‐9 gene with ischemic stroke severity and the risk for END in ischemic stroke (IS) patients with atrial fibrillation (AF). Methods This was a multi‐center, prospective, observational study of 615 acute IS patients with AF admitted to six participating hospitals between June 2016 and October 2017. Ischemic stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score on admission. END was defined as an increase of four or more points in NIHSS within 10 days of admission. Six variants of MMP‐9 gene were examined using mass spectrometry. Results Among the 615 enrolled patients, 112 (18.2%) patients presented with moderate or severe stroke (NIHSS score ≥16), and 108 (17.6%) patients suffered from END within 10 days of admission. Multiple logistic analysis showed that prestroke antiplatelet therapy, prestroke anticoagulant therapy, rs3918242 CT/TT, and rs3787268 AG/GG were independent predictors for stroke severity. Cox proportional hazard regression revealed that diabetes mellitus, prestroke antiplatelet therapy, prestroke anticoagulant therapy, rs1056628 AC/CC, and rs3918242 CT/TT were independently associated with the risk of END. Conclusions The incidence of moderate or severe stroke and END was very common in acute IS patients with AF. MMP‐9 polymorphisms were independently associated with severe stroke and higher risk of END, and prestroke antithrombotic treatment was associated with less severe stroke and lower risk of END in patients with AF.

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“…Previous study demonstrated that the prevalence of proteinuria was higher in the hypertensive group than in the normotensive group (hypertensive group, 33.9%; normotensive, 10%) . Furthermore, data from the China National Stroke Screening Survey (CNSSS) showed that hypertension ranked in first place among factors contributing to stroke in China . The association between proteinuria and stroke, in particular, should be noted in the hypertensive population who are at high risk for the development of stroke.…”

Section: Introductionmentioning

confidence: 99%

“…7 Furthermore, data from the China National Stroke Screening Survey (CNSSS) showed that hypertension ranked in first place among factors contributing to stroke in China. 8 The association between proteinuria and stroke, in particular, should be noted in the hypertensive population who are at high risk for the development of stroke. More important, proteinuria often changes dynamically, showing regression or progression.…”

Section: Introductionmentioning

confidence: 99%

Proteinuria and risk of stroke in patients with hypertension: The Kailuan cohort study

Wang

Dai

et al. 2018

J of Clinical Hypertension

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Proteinuria is associated with stroke, but the effects of changes in proteinuria on stroke risk are not well understood in the hypertensive population. This study examined whether proteinuria changes across 2‐year assessments were associated with incident stroke in individuals with hypertension. We used visit data from 24 300 participants with hypertension of the Kailuan study who were stroke free at baseline. Based on the baseline and 2‐year dipstick screening results, participants were classified as having no, remittent, incident, or persistent proteinuria. The relationship between proteinuria and stroke was analyzed using Cox proportional‐hazards models after adjusting for potential variables. During a median of 6.89‐year follow‐up, we identified 1197 people with stroke. Compared to those with no proteinuria, stroke risk was significantly increased in participants with incident (hazard ratio [HR] 1.41, 95% CI, 1.05‐1.77) and persistent proteinuria (HR 1.49, 95% CI, 1.25‐1.89) after adjustment for other factors, which was consistent in ischemic stroke and intracerebral hemorrhage. No interaction was found between changes of proteinuria and diabetes mellitus in the hypertensive population. Changes in proteinuria exposure, particularly persistent proteinuria, play a role in reflecting the risk of stroke in patients with hypertension.

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Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013

Cited by 176 publications

References 28 publications

Prevalence of stroke and stroke related risk factors: a population based cross sectional survey in southwestern China

Prevalence of stroke and stroke related risk factors: a population based cross sectional survey in southwestern China

Matrix metalloproteinase‐9 gene polymorphisms are associated with ischemic stroke severity and early neurologic deterioration in patients with atrial fibrillation

Proteinuria and risk of stroke in patients with hypertension: The Kailuan cohort study

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