Incidence of ischemic stroke among Chinese residents from 1990 to 2021:An age-period-cohort model analysis

ZHOU Xiaodong; HAO Guangzhi; SU Fanfan; ZHANG Jiahui; MEN Xiaotong; CHU Guangxin

doi:10.3969/j.issn.1671-2897.2026.02.010

Abstract：Objective To investigate the incidence trend of ischemic stroke among Chinese residents from 1990 to 2021 using data from the Global Burden of Disease Database(GBD 2021),and to analyze the impact of age,period,and cohort on this trend.Methods Based on GBD 2021 data,Joinpoint software was utilized to examine the changing trends in ischemic stroke incidence.Additionally,an age-period-cohort model was employed to identify influencing factors and forecast future incidence trends.Results From 1990 to 2021,the incidence of ischemic stroke in the Chinese population exhibited significant fluctuations,with mean annual percentage changes of 1.2%for men and 0.78%for women(1.03%for the total population,P<0.001).The age-period-cohort model analysis revealed that the incidence rate increased with advancing age,peaking in men aged 80～84 years and in women aged 85～89 years.For individuals aged 15～39 years,the incidence rate was lower in males compared to females.However,between the ages of 40 and 89,the incidence rate was higher in males than in females.Recent periods and cohorts showed higher risks,particularly among men compared to women.It is projected that by 2044,the overall incidence will continue to rise,with crude male incidence and standardized incidence rates estimated to be 1.10～1.26 times those of females.Conclusions The incidence of ischemic stroke among Chinese residents has shown an upward trend from 1990 to 2021,with a consistently higher rate observed in males compared to females.Projections indicate that by 2044,the male incidence rate will continue to escalate,further widening the gender disparity.Additionally,the incidence increases with advancing age.Consequently,middle-aged and elderly men constitute a critical demography for targeted ischemic stroke prevention efforts.