Epidemiology and Management of Stroke in China

Stroke represents the foremost cause of mortality and long-term disability in China, driven by demographic ageing and a high prevalence of vascular risk factors. Epidemiological surveys estimate that tens of millions of adults have experienced stroke, with ischaemic subtypes accounting for over 80 % of incident events, and haemorrhagic forms contributing disproportionately to mortality. Rapid urbanisation, dietary changes and rising rates of hypertension, diabetes and dyslipidaemia compound this burden. Regional disparities persist, with northern provinces and rural areas exhibiting higher incidence and poorer control of risk factors. Advances in acute care have seen expanding access to intravenous thrombolysis and mechanical thrombectomy in major centres, while nationwide stroke registries track outcome measures and quality indicators. Secondary prevention through blood pressure and lipid management, antiplatelet therapy, and lifestyle modification is increasingly integrated into primary care. Despite substantial progress, gaps remain in rural coverage, rehabilitation services and long-term adherence to evidence-based interventions. National initiatives, including the Healthy China 2030 Stroke Action Plan, aim to harmonise surveillance, prevention and care to mitigate the growing societal impact of stroke.

Research from Nature Portfolio

Large-scale community surveys have mapped the national prevalence of stroke and associated risk factors among adults aged 40 years and older. These studies reveal an age-standardised prevalence exceeding 1 % in many regions, with higher rates in men, rural dwellers and those with lower educational attainment. Geographical analyses demonstrate a north–south gradient, mirroring variations in hypertension and dyslipidaemia control. Longitudinal data from a single tertiary centre over a decade document shifting proportions of stroke subtypes: ischaemic stroke subcategories such as large-artery atherosclerosis and small-vessel disease have risen, while undetermined-etiology cases have declined. Improvements in lipid-lowering therapies and increased neuroimaging capacity have underpinned these trends, though the incidence of intracerebral haemorrhage remains stable, highlighting the need for intensified blood pressure management.

Epidemiology and Management of Stroke in China publication trend

The graph below shows the total number of articles in epidemiology and management of stroke in china across all publications each year (not limited to Nature Index journals).

Technical terms

Ischaemic stroke: Cerebral infarction due to arterial occlusion impairing blood flow.

Intracerebral haemorrhage: Bleeding within brain parenchyma often linked to hypertension.

Subarachnoid haemorrhage: Bleeding into the subarachnoid space, frequently from aneurysm rupture.

Thrombolytic therapy: Use of clot-dissolving agents to restore cerebral perfusion.

Mechanical thrombectomy: Endovascular removal of an occluding thrombus in acute stroke.

Disability-adjusted life-year (DALY): Composite measure of years lost to disability and premature death.

References

1. China stroke surveillance report 2021. Military Medical Research (2023).
2. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet (2019).
3. Prevalence of Stroke and Vascular Risk Factors in China: a Nationwide Community-based Study. Scientific Reports (2017).
4. Trends in stroke subtypes and vascular risk factors in a stroke center in China over 10 years. Scientific Reports (2018).
5. Effectiveness of a primary care-based integrated mobile health intervention for stroke management in rural China (SINEMA): A cluster-randomized controlled trial. PLOS Medicine (2021).