Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026
Premature ischemic stroke mortality in China to 2030: age- and sex-specific trends and projections.
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Luo Gaoquan, Zhang Yuan, Liu Liu, Fu Ruibin
Аннотация
BACKGROUND: Age-specific evidence is needed to describe premature ischemic stroke mortality in China and to support transparent surveillance through 2030.
METHODS: We analyzed GBD 2023 estimates for China from 1990 to 2023 in eight five-year age groups from 30 to 34 to 65-69 years. Age-specific mortality rates were the primary outcomes. Temporal trends were estimated with log-linear segmented regression. Candidate ARIMA models were compared using rolling-origin validation, information criteria, and residual diagnostics. A 30-69-year study-specific normalized weighted mortality rate was retained only as a secondary sensitivity analysis.
RESULTS: Mortality rates declined across all eight age groups for males, females, and both sexes. In 2023, both-sex rates ranged from 0.44 per 100,000 in ages 30-34 years to 100.03 per 100,000 in ages 65-69 years. Age-specific 2030 forecasts ranged from 0.10 to 35.09 per 100,000 for females and from 0.46 to 107.67 per 100,000 for males. Under the secondary project-existing weighting scheme, the 2030 composite forecasts were 17.46 (95% prediction interval 7.92-27.00) per 100,000 for males, 5.47 (2.34-8.60) for females, and 11.80 (6.64-16.96) for both sexes. These composite estimates are not official GBD age-standardized rates.
CONCLUSIONS: The primary evidence shows substantial age heterogeneity and consistently higher male rates. Conditional forecasts support continued age- and sex-specific surveillance, but they do not establish causal mechanisms, intervention effects, or policy-target attainment.
METHODS: We analyzed GBD 2023 estimates for China from 1990 to 2023 in eight five-year age groups from 30 to 34 to 65-69 years. Age-specific mortality rates were the primary outcomes. Temporal trends were estimated with log-linear segmented regression. Candidate ARIMA models were compared using rolling-origin validation, information criteria, and residual diagnostics. A 30-69-year study-specific normalized weighted mortality rate was retained only as a secondary sensitivity analysis.
RESULTS: Mortality rates declined across all eight age groups for males, females, and both sexes. In 2023, both-sex rates ranged from 0.44 per 100,000 in ages 30-34 years to 100.03 per 100,000 in ages 65-69 years. Age-specific 2030 forecasts ranged from 0.10 to 35.09 per 100,000 for females and from 0.46 to 107.67 per 100,000 for males. Under the secondary project-existing weighting scheme, the 2030 composite forecasts were 17.46 (95% prediction interval 7.92-27.00) per 100,000 for males, 5.47 (2.34-8.60) for females, and 11.80 (6.64-16.96) for both sexes. These composite estimates are not official GBD age-standardized rates.
CONCLUSIONS: The primary evidence shows substantial age heterogeneity and consistently higher male rates. Conditional forecasts support continued age- and sex-specific surveillance, but they do not establish causal mechanisms, intervention effects, or policy-target attainment.