China Stroke Prevention and Control Report 2024: An executive summary

Stroke remains a leading cause of death and disability in China, imposing a substantial burden on public health and the economy. This China Stroke Prevention and Control Report 2024 summary report synthesizes the latest epidemiological data, risk factor management, stroke care systems, quality metrics, and screening interventions based on national surveys, the Global Burden of Disease 2021 study, and the China Stroke High-Risk Population Screening and Intervention Program (CSHR Program). In 2021, China reported 4.09 million new stroke cases, 26.34 million prevalent cases, and 2.59 million deaths, with ischemic stroke comprising the majority. Despite modest declines in age-standardized incidence (3%) and mortality (26%) from 2010 to 2021, absolute numbers continue to rise due to population aging. Key risk factors include hypertension (prevalence 25.5%, control 14.1%), diabetes (11.7%), dyslipidemia (42.1%), and lifestyle factors like smoking and physical inactivity. China's stroke care infrastructure has expanded to 1,962 centers by 2023, with improvements in prehospital response (median call-to-arrival: 39 min) and acute treatments: intravenous thrombolysis rate 9.39%, mechanical thrombectomy rate 2.56%. The CSHR Program screened over 13 million high-risk individuals, revealing gains in awareness but persistent gaps in risk factor control. Analysis of 433,284 hospitalized stroke patients showed median ages of 68, 62, and 61 years for ischemic, intracerebral hemorrhagic, and subarachnoid hemorrhagic strokes, respectively, with in-hospital mortality of 1.20% and three-month disability of 18.13%. Despite progress, challenges remain, including rural-urban disparities, increasing incidence among younger adults, and higher burden in northern regions. Future efforts should focus on primary prevention, equitable access, and integrated care to reduce the national and global stroke burden.