Abstract
Previous studies have shown that Hunan Province has a high incidence of stroke and a high proportion of intracerebral hemorrhage (ICH). Considering the changes over the past three decades, little is known about the current epidemiological characteristics of stroke in Hunan Province. In 2013, a cross-sectional study was conducted at seven national disease surveillance points (DSPs) in Hunan Province. A multistage cluster sampling method was used to select a representative sample. A total of 21,156 participants aged 20 years and older were examined. Among the 21,156 participants, the number of prevalent strokes, incident strokes and deaths was 307, 87, and 36, respectively. The 2010 China census-standardized prevalence, incidence and mortality were 1191.0 per 100,000 people [95% confidence interval (CI) 1044.8–1337.2], 333.6 per 100,000 person-years (95% CI 255.7–411.5) and 129.7 per 100,000 person-years (95% CI 81.1–178.3), respectively. Ischemic stroke (IS), ICH, subarachnoid hemorrhage (SAH), and stroke of undetermined type (UND) constituted 50.6, 41.4, 5.7, and 2.3% of all incident stroke cases, respectively. Tianxin, Liuyang, Wuling, and Hongjiang have high proportions of ICH (61.5, 58.3, 60, and 50%, respectively). Hypertension is the most common risk factor for prevalent stroke (71.34%), followed by smoking (30.62%) and alcohol use (25.73%). In conclusion, Hunan Province has an extremely heavy stroke burden. The high proportion of ICH is not limited to the Changsha community; it represents an important issue for all of Hunan Province.
Highlights
Cerebrovascular disease and ischemic heart disease were the leading causes of years of life lost (YLLs) for both sexes in 123 countries in 2016 [1]
The survey districts in large, medium, and small cities were defined as urban regions, and other survey districts were defined as rural regions
The sample size of Hunan Province was calculated by a multistage stratified cluster sampling method that accounted for national representation in terms of socioeconomic status, geographical distribution, educational level, medical care, and lifestyles
Summary
Cerebrovascular disease and ischemic heart disease were the leading causes of years of life lost (YLLs) for both sexes in 123 countries in 2016 [1]. The Global Disease Burden Report 2015 [2] estimated that from 1990 to 2015, stroke accounted for 47.3% of total disability-adjusted life-years (DALYs) and 67.3% of deaths caused by all neurological disorders. A report by Yang et al showed that stroke was the leading cause of death in China in 2010 [3]. A number of stroke epidemiological studies have been conducted in China since the 1980s. A large stroke epidemiological survey started in 1986 [4], including 5.79 million population samples from 29 provinces and cities in China, and showed that the incidence of stroke in China was 115.9 per 100,000 person-years, and the prevalence of stroke was 259.86 per 100,000 people in China
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