{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:03:26Z","timestamp":1791824606076,"version":"4.3.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Understanding the temporal trends of stroke burden and its attributable risk factors are essential for targeted prevention strategies. We aimed to describe the temporal trends and attributable risk factors of stroke in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on the stroke burden [incidence, prevalence, mortality, and disability-adjusted life years (DALYs)] and the population-attributable fraction for stroke risk factors from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 (GBD 2019). We analyzed trends in the burden of stroke and its attributable risk factors from 1990 to 2019, and the characteristics of stroke-attributable risk factors by sex, age group, and stroke subtype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1990 to 2019, the age-standardized incidence, mortality, and DALY rates for total stroke decreased by 9.3% (3.3, 15.5), 39.8% (28.6, 50.7), and 41.6% (30.7, 50.9) respectively. The corresponding indicators all decreased for intracerebral hemorrhage and subarachnoid hemorrhage. The age-standardized incidence rate of ischemic stroke increased by 39.5% (33.5 to 46.2) for male patients and by 31.4% (24.7 to 37.7) for female patients, and the age-standardized mortality and DALY rates remained almost unchanged. The three leading stroke risk factors were high systolic blood pressure, ambient particulate matter pollution, and smoking. High systolic blood pressure has remained the leading risk factor since 1990. The attributable risk of ambient particulate matter pollution shows a clear upward trend. Smoking and alcohol consumption were important risk factors for men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study reinforced the findings of an increased stroke burden in China. Precise stroke prevention strategies are needed to reduce the disease burden of stroke.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1193056","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T11:00:41Z","timestamp":1684926041000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Stroke burden and attributable risk factors in China, 1990\u20132019"],"prefix":"10.3389","volume":"14","author":[{"given":"Wenxin","family":"Tian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/S1474-4422(18)30500-3","article-title":"Stroke in China: advances and challenges in epidemiology, prevention, and management","volume":"18","author":"Wu","year":"2019","journal-title":"Lancet Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1212\/WNL.0000000000004056","article-title":"Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013","volume":"89","author":"Guan","year":"2017","journal-title":"Neurology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e897","DOI":"10.1016\/S2468-2667(21)00228-0","article-title":"Temporal trend and attributable risk factors of stroke burden in china, 1990-2019: an analysis for the global burden of disease study 2019","volume":"6","author":"Ma","year":"2021","journal-title":"Lancet Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/S0140-6736(20)30977-6","article-title":"Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Wang","year":"2020","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1111\/jgs.16791","article-title":"Cancer prevention and screening for older adults: Part 1 lung, colorectal, bladder, and kidney cancer","volume":"68","author":"Coll","year":"2020","journal-title":"J Am Geriatr Soc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Murray","year":"2020","journal-title":"Lancet."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2248","DOI":"10.1161\/STROKEAHA.118.022161","article-title":"Updated criteria for population-based stroke and transient ischemic attack incidence studies for the 21st century","volume":"49","author":"Feigin","year":"2018","journal-title":"Stroke."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2026","DOI":"10.1038\/s41416-021-01278-0","article-title":"Comparative performance of lung cancer risk models to define lung screening eligibility in the United Kingdom","volume":"124","author":"Robbins","year":"2021","journal-title":"Br J Cancer."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1016\/S0140-6736(18)32225-6","article-title":"2017 Risk Factor Collaborators. 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