Stroke in China
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Recent epidemiologic studies confirm that
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
is the most frequent cause of death in the People's Republic of China, with an incidence more than fivefold that of myocardial infarction.
Intracerebral hemorrhage Intracerebral hemorrhage (ICH), also known as cerebral bleed, intraparenchymal bleed, and hemorrhagic stroke, or haemorrhagic stroke, is a sudden bleeding into Intraparenchymal hemorrhage, the tissues of the brain, into its Intraventricular hemor ...
causes about one third of all strokes, nearly three times the frequency in North American stroke registries. A marked regional variation in stroke incidence exists, with a threefold higher stroke incidence in northern than in southern Chinese cities, suggesting important environmental or dietary influences. Stroke treatment often involves a combination of modern and traditional herbal medicine; the latter may modify platelet aggregation and
blood viscosity Hemorheology, also spelled haemorheology (from Greek ‘αἷμα, ''haima'' 'blood' and rheology, from Greek ῥέω ''rhéō'', ' flow' and -λoγία, ''-logia'' 'study of'), or blood rheology, is the study of flow properties of blood and its ...
. Stroke, particularly intracerebral hemorrhage, is the most frequent and important vascular disorder in China.
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
reports more patients with
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
than anywhere else in the world. While there is still a great deal of unknown information, stroke research has been making great progress in recent years, such as in the areas of clinical research, population and genetic epidemiology, brain ischemia/reperfusion exploring, leukoencephalopathy (CADASIL), neural stem cell and stroke, neuroprotective treatment for stroke, clinical therapy test in stroke, rehabilitation and prevention. Cities and towns in China have integrated systems for registering and investigating strokes. Chinese researchers have followed closely the international level of stroke treatment with a forward position in neural stem cell. Traditional Chinese drugs have featured effects on neuroprotective treatment for stroke which has also been investigated. Chinese scientists have suggested a new way of dividing neuroprotectors in stroke. The clinical therapy test with urokinase and defibrase for cerebral infarction in China is effective and relatively safe, yet the original papers published by Chinese researchers and clinical effects for patient treatment still need to be improved and updated.


Epidemiology

Stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
is the second most common cause of death and leading cause of adult disability in China.Bonita R, Mendis S, Truelsen T, Bogousslavsky J, Toole J, Yatsu F. The global stroke initiative. Lancet Neurol 2004; 3: 391-393. Chronic diseases now account for an estimated 80% of deaths and 70% of disability-adjusted life-years lost in China. The major causes of death in China are vascular disease, cancer, and chronic respiratory disease.Wang LD, Kong LZ, Wu F, Bai YM, Burton R. Preventing chronic diseases in China. Lancet 2005; 366: 1821-1824. Unlike in western countries, cerebrovascular disease predominates; the number of patients who die from stroke is more than three times that from coronary heart disease.Wu ZS, Yao CH, Zhao D, et al
Sino-MONICA project A collaborative study on trends and determinants in cardiovascular diseases in China, part I: morbidity and mortality monitoring.
Circulation 2001; 103: 462-468.
In the past 20 years, China has experienced a rapid economic development. Over time, the proportion of
elderly Old age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human life cycle. Terms and euphemisms for people at this age include old people, the elderly (worldwide usage), OAPs (British usage ...
people in the population will likely increase,
life expectancies Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...
will lengthen, and, as in some other developing countries, the influence of a westernized lifestyle might shift disease patterns towards a profile more similar to that seen in more developed regions, so that the number of strokes will rise. Total age-adjusted incidence of first-ever stroke in China is not very different from that in developed countries. Stroke incidence, mortality, and prevalence varies widely among different regions within China, with a noticeable north–south gradient. The proportion of intracerebral haemorrhage was high and reached 55% in one city.
Hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
is the most important risk factor for stroke. The mass approach combined with a high-risk approach for stroke prevention showed encouraging effects, and various unconventional local therapeutic traditions are commonly used to treat stroke in China. Several national guidelines on stroke prevention and treatment have been developed. Because of methodological limitations in the epidemiology studies, official government data have been unreliable in terms of making any firm conclusions. There have been calls for urgently needed up-to-date, well-designed, and well-done epidemiological studies and therapeutic trials in China.


Further reading

*M. Liu, B. Wu, W. Wang, L. Lee, S. Zhang, L. Kong
Stroke in China: epidemiology, prevention, and management strategies .
''Lancet Neurology'' 2007; 6:456-464
Stroke research in China
Neurological Research, Volume 28, Number 1, January 2006, pp. 11–15(5) *Thomas Truelsen
Epidemiological Transition of Stroke in China?
(Stroke. 2008;39:1653.) * Dong Zhao, Jing Liu, Wei Wang, Zhechun Zeng, Jun Cheng, Jun Liu, Jiayi Sun, and Zhaosu W
Epidemiological Transition of Stroke in China: Twenty-One–Year Observational Study From the Sino-MONICA-Beijing Project
Stroke, June 2008; 39: 1668 - 1674.
Stroke in China (Sino-MONICA-Beijing Study) 1984-1986
Neuroepidemiology 1992;11:15-23
Burden of stroke in China
International Journal of Stroke, Volume 2, Number 3, August 2007, pp. 211–213(3)
Prevention of Stroke in Urban China: A Community-Based Intervention Trial
(Stroke. 1999;30:495-501.)
Proportion of Different Subtypes of Stroke in China
Stroke. 2003
The Fangshan/Family-based Ischemic Stroke Study In China (FISSIC) protocol
BMC Medical Genetics 2007, 8:60 *Gelin Xu
Building a Platform for East-West Communication in Stroke Research: Report of the Third International Stroke Summit, Wuhan, China, November 1–3, 2007
''Cerebrovasc Dis'' 2008;25:279–280 ;Stroke Journals *
Stroke
' AHA *International Journal of Strok

*http://www.basp.ac.uk *http://bmj.com *http://jama.ama-assn.org *http://www.strokejournal.org


See also

* Clinical trial * good clinical practice *
Clinical research associate A clinical research associate (CRA), also called a clinical monitor or trial monitor, is a health-care professional who performs many activities related to medical research, particularly clinical trials. Clinical research associates work in vario ...
*
International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) is an initiative that brings together regulatory authorities and pharmaceutical industry to discuss scientific and technical aspects of pha ...
*
Health informatics Health informatics is the field of science and engineering that aims at developing methods and technologies for the acquisition, processing, and study of patient data, which can come from different sources and modalities, such as electronic hea ...
* National Institute for Health and Clinical Excellence - UK * CHIMES Society - Singapore NGO


References


External links

;Organizations
China Stroke hemiplegia NetworkChinese Stroke Network
;Articles

Stroke Awareness for Everyone SAFE (August 2000)
China's Economic Prosperity Parallels Rising Stroke Rate
March 5, 2008
Smoking is major risk factor for stroke in ChinaWorld Stroke Organization
merger of International Stroke Society ISS and the World Stroke Federation (WSF)
Cochrane Stroke Group
International Conference on Stroke, Chengdu, China, 10–12 March 200
Stroke Rehabilitation in China
University of Southern California
A Chinese Stroke Connection - The Ruth Lycke Story
March/April 2006
Setting priorities in Asian stroke research
{{Health in the People's Republic of China Health in China Stroke