Subtype and gender-differentiated burden of stroke in China (1990–2021): attributable risk factors and future projections based on the Global Burden of Disease Study 2021

作者：Qi Wang, Jiachun Xu, Jingxin Zhang, Jing Tan, Ziqi Wang, Dongjun Wang, Zhen Zhou · 发表于：Frontiers in Nutrition · 年份：2025 · DOI：10.3389/fnut.2025.1687411 · 被引用次数：2 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Sodium Intake and Health

Introduction: Using data from the Global Burden of Disease Study 2021 (GBD 2021), this study analyzed the 32-year trends (1990-2021) of stroke burden in China, quantified the attributable risk factors, and projected the future trajectories (2022-2035) of stroke and its subtypes. It also emphasized subtype- and gender-specific disparities to provide evidence for precision prevention. Methods: Age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR) of stroke were analyzed using estimated annual percentage change (EAPC) and Joinpoint regression. The population attributable fraction (PAF) was used to quantify the burden of stroke-related disability-adjusted life years (DALYs) attributed to risk factors, and Bayesian age-period-cohort (BAPC) modeling was applied to project future burden. Results: In 2021, the ASIR, ASPR, ASMR, and ASDR of stroke in China were 204.75, 1301.42, 138.03, and 2,648.02 per 100,000 populations, respectively. From 1990 to 2021, ASMR (EAPC = -1.92; 95% CI: -2.17 to -1.67) and ASDR (EAPC = -2.05; 95% CI: -2.25 to -1.86) of stroke decreased, while ASPR increased (EAPC = 0.34; 95% CI: 0.31 to 0.38). Subtype analysis showed opposing trends: IS ASIR (EAPC = 0.94; 95% CI: 0.88 to 1.00) and ASPR (EAPC = 1.02; 95% CI: 0.96 to 1.08) increased, whereas ICH and SAH burdens decreased (ICH ASIR EAPC = -2.24; SAH ASIR EAPC = -3.70). Males had higher ASRs than females in 2021, except for ICH AS...