China Stroke Statistics 2019: a wealth of opportunities for stroke prevention
J. David Spence
Abstract
The China Stroke Statistics published in this issue of the journal1 represent an enormous undertaking. It included data on 3 010 204 patients who had a stroke admitted in 2018 to 1853 tertiary care hospitals and compiled data from multiple sources on stroke and stroke risk factors in China. The authors and the huge team of workers who must have compiled the statistics are to be commended on this enormous effort. In the report is a wealth of data on what is wrong in China to cause such a high risk of stroke but also a wealth of opportunity to make a difference. The reason this is so important is that ~80% of strokes are preventable. According to the 2016 Global Burden of Disease Study, China had the highest estimated lifetime risk of stroke from age 25 years onwards of up to 39.3%, compared with 22.2% in Western Europe and 22.4% in high-income North America.2 It is evident from the ratio of strokes to myocardial infarctions in China that hypertension is a major driver of stroke risk. In North America, myocardial infarctions (MI) outnumber strokes, but in China, stroke was historically much more common, though myocardial infarctions have been increasing in recent years. In 2003, in urban China, deaths from stroke were 8.5 times as common as deaths from MI; by 2013, strokes had increased by 26.6%, whereas death from MI increased by 213%, and deaths from stroke were only 2.5 times that of death from MI. This change is no doubt due to increased intake …