Background and Purpose- Population-based studies provide the most reliable data on stroke incidence. A previous systematic review of population-based studies suggested that stroke incidence in high-income countries decreased by 42% between the 1970s and early 2000s. However, it is uncertain whether this trend of steady decline has been maintained in more recent periods. Methods- Data from OCSP (Oxfordshire Community Stroke Project; 1981-1986) and OXVASC (Oxford Vascular Study; 2002-2017) along with other published population-based stroke incidence studies that reported temporal trends of stroke incidence since 1990 in high-income countries were included. Age-standardized relative incidence rate ratios were calculated for each study and then pooled with inverse-variance weighted random-effects meta-analysis. Projection estimates were calculated for the number of incident stroke patients in the United Kingdom from year 2015 to 2045. Results- In Oxfordshire, stroke incidence fell by 32% from OCSP to OXVASC, with a similar trend before or after year 2000. With the projected aging population, if the age-specific stroke incidence continued to decrease at its current rate (6% every 5 years), there would still be a 13% increase of the number of first-ever strokes in the United Kingdom up to year 2045. Incorporating the Oxfordshire data with other 12 population-based studies, stroke incidence declined steadily between the 1990s and 2010s within each study, resulting in a 28% decline over an average period of 16.5 years (pooled incidence rate ratio, 0.72 [95% CI, 0.66-0.79]; P<0.0001). The trend was the same for men (0.69 [95% CI, 0.61-0.77]; P<0.0001) and women (0.66 [95% CI, 0.59-0.74]; P<0.0001) and remained consistent after year 2010 in OXVASC. Proportion of disabling or fatal stroke also decreased over time (early versus later period, 53.6% versus 46.1%; P=0.02). Conclusions- Stroke incidence is continuing to decline with steady rate in Oxfordshire and in other high-income settings. However, the absolute number of strokes occurring is not falling.

中文翻译：

---

21 世纪高收入国家中风发病率趋势：基于人群的研究和系统评价。


背景和目的——基于人群的研究提供了关于中风发病率的最可靠的数据。先前对基于人群的研究进行的系统回顾表明，高收入国家的中风发病率在 1970 年代至 2000 年代初下降了 42%。然而，目前尚不确定这种稳定下降的趋势是否在最近几个时期得到维持。方法 - 数据来自 OCSP（牛津郡社区中风项目；1981-1986 年）和 OXVASC（牛津血管研究；2002-2017 年）以及其他已发表的基于人群的中风发病率研究，这些研究报告了高收入国家自 1990 年以来中风发病率的时间趋势被包括在内。计算每项研究的年龄标准化相对发病率比率，然后通过逆方差加权随机效应荟萃分析进行汇总。对 2015 年至 2045 年英国发生中风患者的数量进行了预测估计。结果 - 在牛津郡，从 OCSP 到 OXVASC，中风发病率下降了 32%，2000 年之前或之后的趋势相似。随着人口老龄化，如果特定年龄的中风发病率继续以目前的速度（每 5 年 6%）下降，到 2045 年，英国首次中风的数量仍将增加 13%。将牛津郡的数据与其他 12 项基于人群的研究相结合，每项研究中的中风发病率在 1990 年代至 2010 年代期间稳步下降，导致平均 16.5 年期间下降 28%（汇总发病率比，0.72 [95% CI， 0.66-0.79]；P<0.0001)。男性 (0.69 [95% CI, 0.61-0.77]; P<0.0001) 和女性 (0.66 [95% CI, 0.59-0.74]; P<0.0001) 的趋势相同，并且一年后保持一致2010 年在 OXVASC。 致残或致命性中风的比例也随着时间的推移而下降（早期与后期，分别为 53.6% 与 46.1%；P=0.02）。结论——牛津郡和其他高收入地区的中风发病率持续稳定下降。然而，中风发生的绝对数量并没有下降。