Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China, 2002–2019, and Predictions to 2030

Abstract

ObjectiveThis study aimed to examine the trends in stroke mortality among young and middle-aged adults in China. MethodsData were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model. ResultsBetween 2002 and 2019, a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded. The age-adjusted mortality rates (AAMRs) of women showed a downward trend. The annual percent changes (APC) were –3.5% (–5.2%, –1.7%) for urban women and –2.8% (–3.7%, –1.9%) for rural women. By contrast, the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46. The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64 years did not change significantly. Between 2020 and 2030, the projected stroke deaths are 1,423,584 in men and 401,712 in women. ConclusionSignificant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China. Targeted health policy measures are needed to address the burden of stroke in the young generation, especially for rural men, with a focus on the prevention and management of high risk factors.