Volume 3 · Issue 1 (2026)
Exploring the Evolution Trend of Stroke Disease Burden in China from 1990 to 2021 Based on the GBD Database
Shuang Wu
Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, Beijing, China
Abstract: Objective: To clarify the long-term evolutionary trends and gender differences of the stroke disease burden in China from 1990 to 2021, and to reveal the correlation between the age-standardized incidence rate (ASIR) and the Socio-demographic Index (SDI), so as to provide a scientific basis for formulating precise prevention and control strategies. Methods: Based on the data from the China Sub-database of the Global Burden of Disease (GBD) 2021, the four core indicators of stroke death counts, Disability-Adjusted Life Years (DALYs), prevalence, and incidence were extracted. Descriptive statistics and gender-stratified analysis were used to sort out the distribution characteristics of the indicators. The Joinpoint regression model was used to analyze time trends and calculate the Average Annual Percent Change (AAPC). Pearson correlation analysis was used to explore the correlation between ASIR and SDI. Results: From 1990 to 2021, the overall stroke disease burden in China showed a significant upward trend, with the highest increase in prevalence (145.40%) and the second highest in incidence (142.60%). The absolute values, growth rates, and annual growth rates of all disease burden indicators for males were higher than those for females, and in 2021, the male prevalence rate overtook that of females. The age-standardized rates showed a fluctuating upward trend, and it is predicted that from 2021 to 2040, male ASIR and ASMR will remain higher than those of females. There are significant regional differences in stroke incidence and prevalence rates, showing a regional clustering feature. ASIR and SDI show a significant negative correlation (r=-0.554, P<0.001). Conclusion: The stroke disease burden in China continues to increase, with males as the key population for prevention and control, and the problem of unbalanced regional prevention and control is prominent. It is necessary to formulate differentiated prevention and control measures based on gender differences and regional epidemiological characteristics.
Keywords: Stroke; Disease Burden; Gender Difference; Socio-demographic Index; ge-standardized Incidence Rate
References
[1]
Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021. 20(10): p. 795-820.
[2]
Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet, 2025. 406(10513): p. 1873-1922.
[3]
Zhang, T., et al., Analysis of Stroke Burden in China from 1990 to 2021 and Projections for the Next Decade. Neuroepidemiology, 2025. 59(5): p. 505-516.
[4]
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024. 403(10440): p. 2100-2132.
[5]
Bai, X., et al., Gender differences in risk factors for ischemic stroke: a longitudinal cohort study in East China. BMC Neurol, 2024. 24(1): p. 171.
[6]
Abdel-Fattah, A.R., et al., Gender differences in mortality of hospitalised stroke patients. Systematic review and meta-analysis. Clin Neurol Neurosurg, 2022. 220: p. 107359.
[7]
Chen, S., et al., Transition and trend analysis of the burden of depression in China and different income countries: Based on GBD database and joinpoint regression model. J Affect Disord, 2024. 362: p. 437-449.
[8]
Weaver, B. and K.L. Wuensch, SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients. Behav Res Methods, 2013. 45(3): p. 880-95.
[9]
Zaheer, S. and F. Yasmeen, Historical trends in breast cancer presentation among women in Pakistan from join-point regression analysis. Pak J Med Sci, 2024. 40(1Part-I): p. 134-139.
[10]
Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol, 2024. 23(10): p. 973-1003.
[11]
Zhu, J., et al., Urban and rural disparities in stroke prediction using machine learning among Chinese older adults. Sci Rep, 2025. 15(1): p. 6779.
[12]
Chapa, D.W., et al., Gender differences in stroke, mortality, and hospitalization among patients with atrial fibrillation: A systematic review. Heart Lung, 2015. 44(3): p. 189-98.
[13]
Carrasquilla, G.D., et al., Postmenopausal hormone therapy and risk of stroke: A pooled analysis of data from population-based cohort studies. PLoS Med, 2017. 14(11): p. e1002445.
[14]
Hoshino, T., et al., Atherogenic Dyslipidemia and Residual Vascular Risk After Stroke or Transient Ischemic Attack. Stroke, 2022. 53(1): p. 79-86.
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