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Keywords:

  • China;
  • epidemiology;
  • incidence;
  • risk factors;
  • rural people;
  • stroke

Background

The aim of this study was to describe the incidence, clinical sub-types, and associated risk factors of stroke among rural Chinese adults.

Methods

A population-based sample of 38 949 rural Chinese adults, aged ≥35 years and free from stroke at baseline, were followed from 2004–2006 to 2010. Stroke was defined by the World Health Organization diagnosis criteria.

Results

The age-standardized incidence rates per 100 000 person-years of overall, first ever stroke was 601·9 (95% confidence interval, 528·3 to 675·5), and mortality rate was 276·7 (95% confidence interval, 251·6 to 301·9). The age-standardized incidence rate was higher in men (775·9 per 100 000 person-years) than in women (435·6 per 100 000 person-years). Among 858 first ever stroke events, 56·3% were ischemic strokes, 40·6% were hemorrhagic strokes, and 3·1% were undetermined strokes. Hypertension and lipid disorder were common modifiable risk factors in the ischemic stroke and hemorrhagic stroke groups.

Conclusions

The annual incidence of stroke and resulting mortality has increased at an accelerated rate. Furthermore, the incidence of stroke in rural China was higher than that found in urban China and Western countries. Hypertension and lipid disorder were important modifiable risk factors. The primary sub-type of stroke observed in rural China was ischemic stroke. These findings underscored the need for more aggressive efforts to control the risk factors of stroke and other cardiovascular diseases in rural areas.