Trends in Stroke Incidence in Hong Kong Differ by Stroke Subtype

Abstract

Background: The population in Hong Kong is mainly Chinese, but their lifestyle is increasingly westernized. It is uncertain whether the trends of stroke in Hong Kong would follow a Chinese or Western pattern. This is the first study to examine the trends of ischemic and hemorrhagic stroke in Hong Kong between 1999 and 2007 with a view to providing data for planning preventive programs and resources for treatment. Methods: Data from the Clinical Management System database of the Hong Kong Hospital Authority for 1999–2007 were used to examine incidence rates of stroke by subtypes among the Hong Kong population aged 35 and above. Poisson regression models were used to examine the trends in the ischemic and hemorrhagic stroke incidence in different subgroups. Results: During 1999–2007, while the age-adjusted incidence of ischemic stroke has decreased, that of hemorrhagic stroke has remained fairly stable. In the younger age group (35–44 years), the incidence of ischemic stroke remained stable, whereas that of hemorrhagic stroke has increased. Furthermore, the incidence of all stroke among Hong Kong Chinese is much higher than in many other developed countries. Conclusions: There were different trends of hemorrhagic and ischemic stroke incidence in Hong Kong. The findings highlight the public health importance of further research into the underlying causes of the increasing trend in hemorrhagic stroke in the younger age group, and the higher overall age-adjusted stroke incidence in Hong Kong compared with other developed countries.

Global Burden of Thrombosis

“…29 Females tend to have lower rates of ischemic stroke, but estimated risk rates have a huge range from 0.7 per 100 000 to 115.3 per 100 000. 27 In the United States, the IRR among males is 1.22 (95% CI, 1.08-1.39) compared with females. 26 In the United States, the incidence of ischemic stroke varies by race.…”

Epidemiology of stroke and its subtypes in Chinese vs white populations

“…Compared with white populations of European origin, Chinese populations have been reported to have a higher incidence of stroke overall, a higher proportion of ICH, and a different distribution of ischemic stroke subtypes. [4][5][6][7][8] However, reliable comparisons have been precluded by a lack of methodologically robust studies of stroke incidence among Chinese populations, age standardization of incidence rates in different studies to different standard populations, and variable methods for classifying stroke types and subtypes. 9,10 Furthermore, no previous review of the epidemiology of stroke in Chinese populations has taken an explicitly systematic approach.…”

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population

“…18 In China, for instance, it was reported that temporal trends of IS incidence have increased over recent years, 19 whereas trends in Hong Kong Chinese were reported to have decreased. 27 A recent systematic review has confirmed the lack of reliable information regarding temporal trends of stroke in most countries in Southeast Asia, despite the substantial impact these countries have on the global burden from cerebrovascular diseases. 17 Their findings indicate the need for reliable epidemiological data from the region that will help to better describe variable trends across countries of different developmental stage, identify mechanisms that are specific to ethnicity, and develop culturally adequate preventive strategies that could have considerable impact on the future global burden of cerebrovascular diseases.…”