Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021

BackgroundStroke remains a principal cause of mortality and disability globally, with approximately 75 percent of strokes affecting individuals aged 65 and older. High fasting plasma glucose (HFPG), high LDL cholesterol (LDL-C), and high systolic blood pressure (SBP) are significant metabolic risk f...

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Main Authors: Haiying Wang, Xiaofeng Wang, Jia Wang, Lin Geng, Shaohua Hou, Pu Li, Qiang Wang, Yali Cui, Shengli Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1607823/full
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author Haiying Wang
Xiaofeng Wang
Jia Wang
Lin Geng
Shaohua Hou
Pu Li
Qiang Wang
Yali Cui
Shengli Sun
author_facet Haiying Wang
Xiaofeng Wang
Jia Wang
Lin Geng
Shaohua Hou
Pu Li
Qiang Wang
Yali Cui
Shengli Sun
author_sort Haiying Wang
collection DOAJ
description BackgroundStroke remains a principal cause of mortality and disability globally, with approximately 75 percent of strokes affecting individuals aged 65 and older. High fasting plasma glucose (HFPG), high LDL cholesterol (LDL-C), and high systolic blood pressure (SBP) are significant metabolic risk factors contributing to the increasing stroke burden. Despite this, the specific impact of these factors on stroke distribution within China, the world’s most populous aging nation, has not been extensively explored. This study investigates the influence of HFPG, LDL-C, and SBP on the stroke burden among China’s elderly population from 1992 to 2021.MethodsUtilizing data from the Global Burden of Disease (GBD) 2021 database, this study assesses the trends in stroke burden attributable to metabolic risks among Chinese individuals aged 65 years and older from 1992 to 2021. Joinpoint regression analysis was employed to identify changes in age-standardized deaths rate (ASDR), while age-period-cohort (APC) analysis helped delineate the roles of age, period, and cohort effects on stroke mortality. Future projections up to 2031 were estimated using autoregressive integrated moving average (ARIMA) models.ResultsThe study period saw a decline in age-standardized rates (ASRs) of stroke-related mortality and disability-adjusted life years (DALYs) across all metabolic risk factors, indicating progress in healthcare and public health efforts. Despite these improvements, the absolute numbers of deaths and DALYs continued to rise, propelled by an aging population and increasing prevalence of metabolic disorders. High SBP [1,241,130 (95% UI: 785,358–1,711,112)] was identified as the most significant contributor to stroke-related mortality among the elderly in China, followed by HFPG [243,757 (95% UI: 175,821–324,600)] and LDL-C [249,106 (95% UI: 70,548–449,517)]. Projections suggest that while ASDR may decrease, the absolute number of stroke-related deaths linked to these metabolic risks will continue to increase through 2031.ConclusionDeveloping effective population-specific strategies targeting high SBP, HFPG, and LDL-C is crucial for substantially reducing the stroke burden among China’s elderly. Given the significant population-attributable fractions of these risk factors, it is vital for China to rigorously evaluate its disease burden and implement targeted prevention and control strategies to mitigate future impacts.
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spelling doaj-art-831e6c0259074acd90fd2ff3ad1cb1bf2025-08-20T03:31:31ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16078231607823Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021Haiying Wang0Xiaofeng Wang1Jia Wang2Lin Geng3Shaohua Hou4Pu Li5Qiang Wang6Yali Cui7Shengli Sun8Department of Science and Education, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, ChinaDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Neurology, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, ChinaDepartment of Neurology, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, ChinaCollege of Life Sciences, Northwest University, Xi’an, ChinaCollege of Life Sciences, Northwest University, Xi’an, ChinaDepartment of Orthopedics, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, ChinaCollege of Life Sciences, Northwest University, Xi’an, ChinaDepartment of Science and Education, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, ChinaBackgroundStroke remains a principal cause of mortality and disability globally, with approximately 75 percent of strokes affecting individuals aged 65 and older. High fasting plasma glucose (HFPG), high LDL cholesterol (LDL-C), and high systolic blood pressure (SBP) are significant metabolic risk factors contributing to the increasing stroke burden. Despite this, the specific impact of these factors on stroke distribution within China, the world’s most populous aging nation, has not been extensively explored. This study investigates the influence of HFPG, LDL-C, and SBP on the stroke burden among China’s elderly population from 1992 to 2021.MethodsUtilizing data from the Global Burden of Disease (GBD) 2021 database, this study assesses the trends in stroke burden attributable to metabolic risks among Chinese individuals aged 65 years and older from 1992 to 2021. Joinpoint regression analysis was employed to identify changes in age-standardized deaths rate (ASDR), while age-period-cohort (APC) analysis helped delineate the roles of age, period, and cohort effects on stroke mortality. Future projections up to 2031 were estimated using autoregressive integrated moving average (ARIMA) models.ResultsThe study period saw a decline in age-standardized rates (ASRs) of stroke-related mortality and disability-adjusted life years (DALYs) across all metabolic risk factors, indicating progress in healthcare and public health efforts. Despite these improvements, the absolute numbers of deaths and DALYs continued to rise, propelled by an aging population and increasing prevalence of metabolic disorders. High SBP [1,241,130 (95% UI: 785,358–1,711,112)] was identified as the most significant contributor to stroke-related mortality among the elderly in China, followed by HFPG [243,757 (95% UI: 175,821–324,600)] and LDL-C [249,106 (95% UI: 70,548–449,517)]. Projections suggest that while ASDR may decrease, the absolute number of stroke-related deaths linked to these metabolic risks will continue to increase through 2031.ConclusionDeveloping effective population-specific strategies targeting high SBP, HFPG, and LDL-C is crucial for substantially reducing the stroke burden among China’s elderly. Given the significant population-attributable fractions of these risk factors, it is vital for China to rigorously evaluate its disease burden and implement targeted prevention and control strategies to mitigate future impacts.https://www.frontiersin.org/articles/10.3389/fneur.2025.1607823/fullstrokemetabolic risk factorsage-standardized deaths rateautoregressive integrated moving average (ARIMA) modelspopulation aging
spellingShingle Haiying Wang
Xiaofeng Wang
Jia Wang
Lin Geng
Shaohua Hou
Pu Li
Qiang Wang
Yali Cui
Shengli Sun
Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
Frontiers in Neurology
stroke
metabolic risk factors
age-standardized deaths rate
autoregressive integrated moving average (ARIMA) models
population aging
title Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
title_full Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
title_fullStr Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
title_full_unstemmed Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
title_short Temporal trends and epidemiological impact of metabolic risk factors on stroke burden in Chinese individuals aged 65 and older, 1992–2021
title_sort temporal trends and epidemiological impact of metabolic risk factors on stroke burden in chinese individuals aged 65 and older 1992 2021
topic stroke
metabolic risk factors
age-standardized deaths rate
autoregressive integrated moving average (ARIMA) models
population aging
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1607823/full
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