Increasing stroke incidence and prevalence of risk factors in a low-income Chinese population

Objective: We investigated secular trends in incidence of first-ever stroke and the prevalence of stroke risk factors within the same population in rural China. Methods: In 1985, 15,438 residents from a township of Tianjin, China, were recruited to the Tianjin Brain Study, a population-based stroke surveillance study. Stroke events and all deaths were registered annually. Because imaging technology was first available in 1992, we analyzed the incidence of first-ever stroke over 3 study periods—1992–1998, 1999–2005, and 2006–2012—from 1992 to 2012. Risk factor surveys were conducted in 1991 and 2011. Results: The age-standardized incidence of first-ever stroke per 100,000 person-years increased rapidly from 124.5 in 1992–1998 to 190.0 in 1999–2005 and to 318.2 in 2006–2012; incidence increased annually by 6.5% overall and by 12% among men aged 45–64 years (p Conclusions: The incidence of stroke in rural China increased rapidly, particularly among middle-aged adults, along with a concurrent increase in risk factor prevalence. These findings suggest that without controlling these risk factors, stroke incidence will continue to increase over future decades in China.