Stroke in China: advances and challenges in epidemiology, prevention, and management

Abstract

With over 2 million new cases annually, stroke is associated with the highest disability-adjusted life-years lost of any disease in China. The burden is expected to increase further as a result of population ageing, an ongoing high prevalence of risk factors (eg, hypertension), and inadequate management. Despite improved access to overall health services, the availability of specialist stroke care is variable across the country, and especially uneven in rural areas. In-hospital outcomes have improved because of a greater availability of reperfusion therapies and supportive care, but adherence to secondary prevention strategies and long-term care are inadequate. Thrombolysis and stroke units are accepted as standards of care across the world, including in China, but bleeding-risk concerns and organisational challenges hamper widespread adoption of this care in China. Despite little supporting evidence, Chinese herbal products and neuroprotective drugs are widely used, and the increased availability of neuroimaging techniques also results in overdiagnosis and overtreatment of so-called silent stroke. Future efforts should focus on providing more balanced availability of specialised stroke services across the country, enhancing evidence-based practice, and encouraging greater translational research to improve outcome of patients with stroke.

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Affiliated Institutions

• Royal Prince Alfred Hospital AU
• Peking University First Hospital CN
• Chongqing Medical University CN
• The George Institute for Global Health AU
• George Institute for Global Health CN
• Beijing Tian Tan Hospital CN
• West China Hospital of Sichuan University CN
• State Key Laboratory of Biotherapy
• Chinese PLA General Hospital CN
• National Health and Family Planning Commission CN
• Nanjing Medical University CN
• Xuan Wu Hospital of the Capital Medical University CN
• Peking University Third Hospital CN
• Tongji Hospital CN
• University of Oxford GB
• The Affiliated Yongchuan Hospital of Chongqing Medical University CN
• Capital Medical University CN
• China Rehabilitation Research Center CN
• UNSW Sydney AU
• Peking University CN
• University of Edinburgh GB
• Peking Union Medical College Hospital CN
• Nanjing General Hospital of Nanjing Military Command CN
• Nanjing University CN
• Beijing Institute of Neurosurgery CN
• Chinese University of Hong Kong HK
• Huazhong University of Science and Technology CN
• Chinese Academy of Medical Sciences & Peking Union Medical College CN
• Sichuan University CN

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