1990 - 2021年中国吸烟引起的中风和中风亚型变化模式及2050年预测

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-06-04 DOI:10.1016/j.jstrokecerebrovasdis.2025.108368

Bo Hei , Jiayu Liu , Jixia Fang , Qun Gao , Bin Wang , Wu Zhou , Jingru Zhou

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引用次数: 0

摘要

背景：吸烟是否对中风及其亚型有类似的影响尚不确定。本研究的目的是评估1990年至2021年中国吸烟导致的中风和亚型的长期趋势，并预测到2050年的变化。方法：从全球疾病负担（GBD） 2021中提取中国因吸烟导致的脑卒中及其亚型死亡率数据。采用线性回归和年龄-时期-队列模型计算年龄标准化死亡率（ASMR）趋势，采用贝叶斯年龄-时期-队列（BAPC）模型预测2022 - 2050年的趋势。结果：中国吸烟所致卒中的ASMR变化趋势在不同亚型之间存在差异，脑出血（ICH）的年变化百分比（EAPC）估计为-2.40；缺血性卒中(IS) -0.67；蛛网膜下腔出血（SAH）为-0.65。局部漂移曲线反映了各年龄组吸烟引起的脑卒中死亡率的年平均百分比变化，在脑卒中和亚型中呈下降趋势。在所有年龄组中，SAH死亡率的下降幅度远大于IS和ICH。期间率比（PRR）和队列率比（CRR）因亚型而异，所有亚型均呈下降趋势。IS和ICH的死亡率随着年龄的增长而显著增加；SAH的死亡率先上升后下降，在65-70岁年龄组达到顶峰。最后，从2022年到2050年，中国可归因于吸烟的卒中和亚型的ASMR和ASDR将继续下降。结论：我们的研究表明，1990年至2021年，中国因吸烟导致的脑卒中负担有所下降，但仍高于全球水平，并在2022年至2050年继续下降。IS的下降幅度最小，尤其是在老年男性中。尽管青少年吸烟率的上升——尤其是女性吸烟率的上升——构成了威胁，但预计情况仍将持续改善。加强烟草控制、戒烟和有针对性的IS预防至关重要，尤其是在老年男性中。

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Changing patterns of stroke and subtypes attributable to smoking from 1990 to 2021 in China and projections to 2050

Background

It is uncertain whether smoking exerts similar effects on the stroke and subtypes. The aim of this study was to assess the long-term trends of stroke and subtypes attributable to smoking in China from 1990 to 2021 and to predict changes to 2050.

Methods

Data on stroke and its subtypes mortality attributable to smoking in China were extracted from the Global Burden of Disease (GBD) 2021. Linear regression and age-period-cohort models were used to calculate age-standardised mortality rate (ASMR) trends, and the BAPC (Bayesian age-period-cohort) model was used to predict trends from 2022 to 2050.

Results

The changing trend of ASMR on stroke attributable to smoking in China differed among subtypes, with an estimated annual percentage change (EAPC) of -2.40 for intracerebral hemorrhage (ICH); -0.67 for ischemic stroke (IS); -0.65 for subarachnoid hemorrhage (SAH). The local drift curves reflect the average annual percentage change in stroke mortality attributable to smoking in all age groups, with a decreasing trend in stroke and subtypes. The decline in SAH mortality was much greater than for IS and ICH across all age groups. The period rate ratio (PRR) and cohort rate ratio (CRR) varied by subtype, showing the decline for all subtypes. Mortality rates for IS and ICH increase significantly with age; the mortality rate for SAH increases followed by a decrease, peaking in the 65-70 year age group. Finally, the ASMR and ASDR for stroke and subtypes attributable to smoking in China will continue to decline from 2022 to 2050.

Conclusions

Our study shows that stroke burden attributable to smoking in China declined from 1990 to 2021 but remained higher than global levels, with continue to decline from 2022 to 2050. IS showed the least reduction, especially among older men. Projections suggest continued improvement, though rising adolescent smoking—particularly among women—poses a threat. Strengthened tobacco control, smoking cessation, and targeted IS prevention, especially in older males, are crucial.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.