ABSTRACT NUMBER: ESOC2026A631 STROKE BURDEN ATTRIBUTABLE TO ITS RISK FACTORS IN CHINA AND ITS PROVINCES, 1990-2021

Abstract Background and aims A comprehensive assessment of the stroke burden attributable to modifiable risk factors is critical for evidence-based policymaking. We aimed to assess the temporal trends of stroke burden attributable to its risk factors in China and its provinces during 1990-2021. Methods We calculated stroke-related mortality and disability-adjusted life-years (DALY) attributable to 33 risk factors from 1990 to 2021 in China and its provinces, using the standard methodology of Global Burden of Diseases (GBD) 2021. Results In China, the estimated number of stroke-related DALY attributable to all risk factors increased from 31.8 million in 1990 to 45.5 million in 2021, while the age-standardised DALY rate (ASDR) decreased from 4,092.3/100,000 to 2,236.1/100,000. In 2021, metabolic risks contributed to the highest proportion of ASDR for stroke (67.7%), followed by environmental risks (40.6%) and behavioral risks (40.5%). In 2021, the top five risk factors of stroke-related DALY rate were high systolic blood pressure, particulate matter pollution, smoking, diet high in sodium and high LDL cholesterol. Notably, the ASDR for stroke attributable to ambient particulate matter pollution, diet high in processed meat and sugar-sweetened beverages and high BMI showed significant upward trends during 1990-2021. Moreover, Tibet (4,753/100,000), Qinghai (3,300/100,000), Guizhou (3,260/100,000) were the top three provinces holding the highest ASDR for stroke attributable to all risk factors in 2021. Conclusions While China has made progress in reducing stroke burden associated with its risk factors, metabolic risks remained the major challenge. Tailored, region-specific strategies for stroke risk factors are critically needed to effectively reduce the stroke burden in China. Conflict of interest Zixin Wang, Jiamin Li, Yun Chen, Wan Wang, Boyi Yuan, Qingfeng Ma: nothing to disclose.