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cohort·epidemiology, public health, neurology, cardiology, endocrinology·PMC10022731

High-risk population and factors of stroke has changed among middle-aged and elderly Chinese—Evidence from 1989 to 2015

Frontiers in Public Health · 4 authors, 3 centres

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TL;DR

This study analyzed survey data from 1989 to 2015 to track changes in stroke prevalence, risk factors, and high-risk groups among 42,419 middle-aged and elderly Chinese residents. The central result is that while overall stroke prevalence decreased, the leading risk factors and high-risk populations shifted from age and hypertension toward lifestyle and regional factors like BMI, diabetes, and living in certain areas.

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Chi-square tests, Shapley value decomposition, and decision tree models were applied. The overall prevalence of stroke decreased over the study period. The contribution of age as a risk factor also declined. Conversely, the influence of factors like body mass index (BMI), diabetes, sleep duration, and living area grew. High-risk populations shifted from being defined by hypertension and advanced age to being characterized by marital status (without spouse), urban residence, and comorbidities (e.g., hypertension with diabetes).

STUDY TYPE

cohort

SPECIALTY

epidemiology

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AI pipeline

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ORIGINAL PAPER

PMC10022731

High-risk population and factors of stroke has changed among middle-aged and elderly Chinese—Evidence from 1989 to 2015

Frontiers in Public Health

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ABSTRACT

Background Stroke is an acute cerebrovascular disease with high mortality and disability. This study aimed to investigate the trend of stroke prevalence from 1989 to 2015 in China, explore the transition of high-risk population and high-risk factors, and provide some evidence to develop more targeted stroke intervention strategies. Material and methods We derived the baseline data from China Health and Nutrition Survey (CHNS). Participants responded to face-to-face interviews and examinations containing demographic information, behavioral health information, disease history, and physical examination. We applied chi-square test, shapley value decomposition model, and decision tree model to evaluate the changes of high-risk population and high-risk factors of stroke. Results Across 42,419 middle-aged and elderly residents, the prevalence of stroke was decreasing from 1989 to 2015. Hypertension was the leading risk factor of stroke, while its contribution rate was weakened with the increasing of medicine taking rate. As the second risk factor of stroke, the contribution of age decreased either. Meanwhile, the contribution rate of historical health factors, lifestyle factors, and regional factors, such as body mass index, diabetes, and living area to the impact of stroke was increasing. In addition, the first high-risk population of stroke changed from hypertension patients aged 75 years and above to without spouse residents living in stroke belt such as Beijing and Liaoning. The second risk population of stroke transformed from male hypertensive patients under 75 years old into male hypertensive patients living in urban. The third high-risk group turned from the elderly aged 75 and above into the female patients with hypertension and diabetes. Conclusions This study demonstrated that the high-risk population and high-risk factors of stroke changed in China and revealed the direction and internal mechanism of transition of stroke. Targeted stroke intervention strategies should be renewed. Health education for the high-risk population of stroke should be carried out, healthy living habits need be advocated, and the use of antihypertensive drugs for the hypertensive patients should be standardized.

CITATION EXPORT

Xue Zhang, Jing Dai, Wei Li et al.. High-risk population and factors of stroke has changed among middle-aged and elderly Chinese—Evidence from 1989 to 2015. Frontiers in Public Health. (2023). https://doi.org/10.3389/fpubh.2023.1090298

AUTHORS

4 · 3 CENTRES

Xue Zhang, Jing Dai, Wei Li, Yunjuan Yang

1Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, China
2Department of Party Committee, The First People's Hospital of Yunnan Province, Kunming, China
3Yunnan Provincial Center for Disease Control and Prevention, Kunming, China