Abstract：
OBJECTIVE: The objective of this study was to study the primary risk factors for the long-term trends of mortality rates in ischemic stroke (IS) in China.
METHODS: Using the Global Burden of Disease Study 2019 (GBD 2019) database, research was conducted on the 11 primary risk factors for the mortality rates of IS in China from 1990 to 2019. This study employed joinpoint regression software and the age-period-cohort method to evaluate the trends of mortality rates divided by age, period, and cohort over time.
RESULTS: From 1990 to 2019, the age-standardized mortality rate (ASMR) caused by a diet high in red meat and high body mass index in China showed an upward trend. ASMR increased first and then decreased due to smoking, diet high in sodium, particulate matter pollution, high fasting plasma glucose, and high systolic blood pressure. Low-density lipoprotein cholesterol (LDL-C), kidney dysfunction, low temperature, and lead exposure remained relatively stable during this period. In the 35-45 age group, the mortality rate of IS due to high LDL-C was up to about 60%, and smoking affected men more than women. Overall, high LDL-C, high systolic blood pressure, and particulate matter pollution were the most common risk factors in patients with IS. The risk of death rose with age. The period and cohort relative risks showed that metabolic risk factors had the greatest impact on the mortality of IS.
CONCLUSIONS: Metabolic risk factors have become the primary risk factors for the ASMR of IS in China. Relevant authorities should pay attention to their long-term effects on IS. Effective public health policies and interventions should be implemented to reduce the burden of IS.
METHODS: Using the Global Burden of Disease Study 2019 (GBD 2019) database, research was conducted on the 11 primary risk factors for the mortality rates of IS in China from 1990 to 2019. This study employed joinpoint regression software and the age-period-cohort method to evaluate the trends of mortality rates divided by age, period, and cohort over time.
RESULTS: From 1990 to 2019, the age-standardized mortality rate (ASMR) caused by a diet high in red meat and high body mass index in China showed an upward trend. ASMR increased first and then decreased due to smoking, diet high in sodium, particulate matter pollution, high fasting plasma glucose, and high systolic blood pressure. Low-density lipoprotein cholesterol (LDL-C), kidney dysfunction, low temperature, and lead exposure remained relatively stable during this period. In the 35-45 age group, the mortality rate of IS due to high LDL-C was up to about 60%, and smoking affected men more than women. Overall, high LDL-C, high systolic blood pressure, and particulate matter pollution were the most common risk factors in patients with IS. The risk of death rose with age. The period and cohort relative risks showed that metabolic risk factors had the greatest impact on the mortality of IS.
CONCLUSIONS: Metabolic risk factors have become the primary risk factors for the ASMR of IS in China. Relevant authorities should pay attention to their long-term effects on IS. Effective public health policies and interventions should be implemented to reduce the burden of IS.
摘要：
目的：研究中国缺血性卒中（IS）死亡率长期趋势的主要危险因素。
方法：使用2019年全球疾病负担研究（GBD2019）数据库，对1990年至2019年中国IS死亡率的11个主要危险因素进行了研究。本研究采用Joinpoint回归软件和年龄-周期-队列（APC）方法来评估死亡率除以年龄的趋势，period,随着时间的推移和队列。
结果：从1990年到2019年，中国高红肉饮食和高体重指数（BMI）引起的年龄标准化死亡率（ASMR）呈上升趋势。由于吸烟，ASMR先升高后降低，高钠饮食，颗粒物污染，空腹血糖高，高收缩压.低密度脂蛋白胆固醇(LDL-C),肾功能不全,低温,在此期间，铅暴露保持相对稳定。在35-45岁年龄段，由于高LDL-C导致的IS死亡率高达约60％，吸烟对男性的影响大于女性。总的来说,高LDL-C,高收缩压,颗粒物污染是IS患者最常见的危险因素。死亡的风险随着年龄的增长而上升。周期和队列相对风险表明，代谢危险因素对IS死亡率的影响最大。
结论：代谢危险因素已成为中国ISASMR的主要危险因素。有关当局应注意其对IS的长期影响。应实施有效的公共卫生政策和干预措施，以减轻IS的负担。
方法：使用2019年全球疾病负担研究（GBD2019）数据库，对1990年至2019年中国IS死亡率的11个主要危险因素进行了研究。本研究采用Joinpoint回归软件和年龄-周期-队列（APC）方法来评估死亡率除以年龄的趋势，period,随着时间的推移和队列。
结果：从1990年到2019年，中国高红肉饮食和高体重指数（BMI）引起的年龄标准化死亡率（ASMR）呈上升趋势。由于吸烟，ASMR先升高后降低，高钠饮食，颗粒物污染，空腹血糖高，高收缩压.低密度脂蛋白胆固醇(LDL-C),肾功能不全,低温,在此期间，铅暴露保持相对稳定。在35-45岁年龄段，由于高LDL-C导致的IS死亡率高达约60％，吸烟对男性的影响大于女性。总的来说,高LDL-C,高收缩压,颗粒物污染是IS患者最常见的危险因素。死亡的风险随着年龄的增长而上升。周期和队列相对风险表明，代谢危险因素对IS死亡率的影响最大。
结论：代谢危险因素已成为中国ISASMR的主要危险因素。有关当局应注意其对IS的长期影响。应实施有效的公共卫生政策和干预措施，以减轻IS的负担。
