What does this research mean for the field?

China's ischemic stroke burden exhibits a distinct trajectory characterized by rising incidence and a delayed decline in mortality, diverging significantly from the sustained reductions observed in other G20 nations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to assess the burden of ischemic stroke and its trends across China and G20 nations from 1990 to 2021, projecting future trends.

March 21, 2026Health care science0 citationsOpen Access

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Ischemic Stroke Burden in China and Other G20 Nations (1990–2021): A Comparative Analysis From the Global Burden of Disease Study 2021 and Trend Projections Through 2031

BLBin LuoHebei Medical University YXYi XiangBeijing Sanbo Brain Hospital HRHecheng RenTianjin University of Technology

Key Points

The study aims to assess the burden of ischemic stroke and its trends across China and G20 nations from 1990 to 2021, projecting future trends.
Analyzed Global Burden of Disease 2021 data for ischemic stroke statistics
Calculated age-standardized incidence and mortality rates, disability-adjusted life years, and mortality-to-incidence ratios
Utilized Joinpoint regression for trend analysis and autoregressive integrated moving average for projections
Stratified data by age and sex and correlated with the Socio-demographic Index
China's crude incidence of ischemic stroke increased by 27.4% from 1990 to 2021, contrasting with declines in G20 nations
Age-standardized mortality rates and disability-adjusted life years decreased globally, but China's mortality rates showed a temporary increase between 1999 and 2004
Projections indicate rising incidence rates in China with stable mortality rates, diverging from the G20 trends of declining mortality
Socio-demographic Index disparities persist, with China's incidence and mortality rates exceeding G20 averages relative to SDI

Abstract

ABSTRACT Background Ischemic stroke (IS) persists as a major global health challenge. This study assesses IS burden, epidemiological trends, and associations with the Socio‐demographic Index (SDI) across China and G20 nations (1990–2021), projecting trends to 2031 to inform resource prioritization. Methods Utilizing Global Burden of Disease (GBD) 2021 data, we analyzed age‐standardized incidence rates (ASIR) and age‐standardized mortality rates (ASMR), disability‐adjusted life years (DALYs), and mortality‐to‐incidence ratio (MIR) using Joinpoint regression (trends), autoregressive integrated moving average (projections), and Pearson correlation (SDI linkage), stratified by age and sex. Results From 1990 to 2021, China experienced rising crude IS incidence (+27.4%) contrasting with G20 declines. Although ASMR and DALYs decreased globally, China's ASMR initially increased (1999–2004) before declining, unlike sustained G20 reductions. China's ASIR rose 35.7% versus a 15.6% G20 reduction. Projections indicate stable ASMR with rising ASIR in China, diverging from declining ASMR and stable ASIR in the G20. SDI‐linked disparities persisted, with China's ASIR/ASMR exceeding G20 averages relative to SDI. Conclusion China's distinct trajectory—characterized by rising incidence and delayed mortality decline—underscores the necessity for tailored interventions. Addressing SDI‐driven disparities is essential for equitable global prevention and care strategies.

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Ischemic Stroke Burden in China and Other G20 Nations (1990–2021): A Comparative Analysis From the Global Burden of Disease Study 2021 and Trend Projections Through 2031

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Abstract

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