Table 1.
Temporal trends in age-standardized rates of ischemic stroke burden in China and the United States, 1990 to 2023.
| Location | Gender | Indicator | Cases in 1990 (n) | Cases in 2023 (n) | Change in Cases (%) | Age-standardized rate in 1990 (per 100,000) | Age-standardized rate in 2023 (per 100,000) | Change in age-standardized rate (%) | EAPC (95% CI) | AAPC (95% CI) | AAPC P-value |
|---|---|---|---|---|---|---|---|---|---|---|---|
| China | Both | Incidence | 876,167 | 2,656,475 | 203.19 | 112.33 | 118.4 | 5.41 | 0.06 (−0.09 to 0.22) |
0.13 (0.09 to 0.17) | <.001 |
| China | Female | Incidence | 389,802 | 1,066,643 | 173.64 | 96.09 | 91 | −5.3 | −0.21 (−0.36 to −0.07) |
−0.19 (−0.22 to −0.16) | <.001 |
| China | Male | Incidence | 486,364 | 1,589,832 | 226.88 | 131.66 | 148.51 | 12.8 | 0.23 (0.07 to 0.39) |
0.30 (0.24 to 0.36) | <.001 |
| China | Both | Prevalence | 7,436,521 | 21,229,135 | 185.47 | 851.25 | 953.08 | 11.96 | 0.44 (0.41 to 0.46) |
0.34 (0.33 to 0.34) | <.001 |
| China | Female | Prevalence | 3,478,183 | 9,165,813 | 163.52 | 775.23 | 801.83 | 3.43 | 0.14 (0.11 to 0.16) |
0.10 (0.09 to 0.10) | <.001 |
| China | Male | Prevalence | 3,958,338 | 12,063,322 | 204.76 | 939.75 | 1115.83 | 18.74 | 0.66 (0.62 to 0.7) |
0.52 (0.52 to 0.53) | <.001 |
| China | Both | Deaths | 590,439 | 860,343 | 45.71 | 94.12 | 39.34 | −58.2 | −2.68 (−2.84 to −2.51) |
−2.52 (−2.60 to −2.44) | <.001 |
| China | Female | Deaths | 284,203 | 368,634 | 29.71 | 82.96 | 30.72 | −62.97 | −3.11 (−3.33 to −2.9) |
−2.91 (−2.98 to −2.84) | <.001 |
| China | Male | Deaths | 306,236 | 491,709 | 60.57 | 108.43 | 49.42 | −54.42 | −2.36 (−2.5 to −2.22) |
−2.25 (−2.37 to −2.12) | <.001 |
| China | Both | DALYs | 13,378,094 | 18,090,920 | 35.23 | 1783.23 | 802.71 | −54.99 | −2.48 (−2.61 to −2.36) |
−2.33 (−2.41 to −2.26) | <.001 |
| China | Female | DALYs | 6,110,070 | 7,336,193 | 20.07 | 1545.95 | 615.52 | −60.19 | −2.94 (−3.1 to −2.78) |
−2.71 (−2.78 to −2.66) | <.001 |
| China | Male | DALYs | 7,268,024 | 10,754,727 | 47.97 | 2062.32 | 1009.23 | −51.06 | −2.17 (−2.28 to −2.05) |
−2.08 (−2.17 to −1.99) | <.001 |
| United States of America | Both | Incidence | 304,213 | 388,155 | 27.59 | 96.17 | 70.04 | −27.17 | −0.67 (−0.8 to −0.54) |
−0.94 (−0.97 to −0.91) | <.001 |
| United States of America | Female | Incidence | 156,619 | 180,861 | 15.48 | 82.88 | 59.72 | −27.95 | −0.75 (−0.87 to −0.63) |
−0.97 (−1.00 to −0.94) | <.001 |
| United States of America | Male | Incidence | 147,594 | 207,294 | 40.45 | 113.07 | 81.63 | −27.8 | −0.63 (−0.78 to −0.49) |
−0.97 (−1.00 to −0.94) | <.001 |
| United States of America | Both | Prevalence | 3,480,013 | 6,674,890 | 91.81 | 1129.46 | 1252.89 | 10.93 | 0.18 (0.07 to 0.3) |
0.34 (0.32 to 0.35) | <.001 |
| United States of America | Female | Prevalence | 1,772,390 | 3,215,234 | 81.41 | 1004.65 | 1143.96 | 13.87 | 0.23 (0.06 to 0.4) |
0.42 (0.39 to 0.44) | <.001 |
| United States of America | Male | Prevalence | 1,707,623 | 3,459,656 | 102.6 | 1292.86 | 1381.11 | 6.83 | 0.1 (0.04 to 0.17) |
0.22 (0.20 to 0.24) | <.001 |
| United States of America | Both | Deaths | 99,697 | 118,039 | 18.4 | 29.78 | 17.75 | −40.4 | −2 (−2.33 to −1.67) |
−1.38 (−1.48 to −1.27) | <.001 |
| United States of America | Female | Deaths | 62,162 | 72,264 | 16.25 | 27.98 | 17.73 | −36.63 | −1.76 (−2.05 to −1.48) |
−1.23 (−1.33 to −1.13) | <.001 |
| United States of America | Male | Deaths | 37,535 | 45,774 | 21.95 | 31.9 | 17.19 | −46.12 | −2.4 (−2.81 to −1.98) |
−1.72 (−1.82 to −1.60) | <.001 |
| United States of America | Both | DALYs | 1,882,131 | 2,456,713 | 30.53 | 575.17 | 411.32 | −28.49 | −1.36 (−1.6 to −1.12) |
−0.91 (−0.98 to −0.84) | <.001 |
| United States of America | Female | DALYs | 1,069,962 | 1,342,141 | 25.44 | 526.53 | 395.3 | −24.92 | −1.19 (−1.38 to −0.99) |
−0.77 (−0.83 to −0.71) | <.001 |
| United States of America | Male | DALYs | 812,169 | 1,114,572 | 37.23 | 637.52 | 425.21 | −33.3 | −1.61 (−1.92 to −1.31) |
−1.10 (−1.17 to −1.02) | <.001 |
ASR = age-standardized rate; CI = confidence interval; DALY = disability-adjusted life year.
Notes: Age-standardized rates per 100,000 population for incidence, prevalence, mortality, and DALYs of ischemic stroke in China and the United States from 1990 to 2023, stratified by sex. The table presents baseline values (1990), endpoint values (2023), absolute change, percentage change, and estimated annual percentage change (EAPC) with 95% confidence intervals. EAPC was calculated using log-linear regression to quantify the average annual rate of change. Positive EAPC values indicate increasing trends, while negative values indicate decreasing trends. Trends were considered statistically significant when the 95% CI of EAPC did not include zero.