19 April 2026 : Database Analysis
Divergent Trends in Stroke Subtype Mortality Attributable to High Systolic Blood Pressure in China, 1990 to 2021: An Age-Period-Cohort Analysis and Projection
Yaoyao Li A 1, Linfeng Li B 1,2, Min Wang C 3, Qiaohong Xu D 4, Lixin Liu D 1,2, Xinyi Wang E 1,2, Xue Liu F 1,2, Hengjie Li A 1, Fahuan Song A 3, Wenwei Cai A 1*DOI: 10.12659/MSM.951794
Med Sci Monit 2026; 32:e951794
Table 1 Joinpoint regression results for ASMRs of stroke and stroke subtypes attributable to high systolic blood pressure in China, 1990 to 2021 (maximum 5 joinpoints).
| Both sexes | Women | Men | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Segment | Period | APC (95% CI) | P value | Segment | Period | APC (95% CI) | P value | Segment | Period | APC (95% CI) | P value | |
| Stroke | 1 | 1990–1998 | −0.42 (−0.60 to −0.25) | <0.001 | 1 | 1990–1998 | −0.80 (−0.97 to −0.64) | <0.001 | 1 | 1990–1999 | 0.13 (−0.08 to 0.34) | 0.207 |
| 2 | 1998–2004 | 1.64 (1.30 to 1.98) | <0.001 | 2 | 1998–2004 | 1.02 (0.69 to 1.34) | <0.001 | 2 | 1999–2004 | 2.92 (2.20 to 3.64) | <0.001 | |
| 3 | 2004–2007 | −5.32 (−6.69 to −3.93) | <0.001 | 3 | 2004–2007 | −6.36 (−7.61 to −5.08) | <0.001 | 3 | 2004–2007 | −4.35 (−6.40 to −2.24) | 0.001 | |
| 4 | 2007–2010 | −0.62 (−2.03 to 0.81) | 0.366 | 4 | 2007–2010 | −1.56 (−2.89 to −0.21) | 0.026 | 4 | 2007–2010 | 0.07 (−1.97 to 2.16) | 0.941 | |
| 5 | 2010–2015 | −3.78 (−4.21 to −3.34) | <0.001 | 5 | 2010–2014 | −5.05 (−5.71 to −4.38) | <0.001 | 5 | 2010–2015 | −3.28 (−3.90 to −2.65) | <0.001 | |
| 6 | 2015–2021 | −1.61 (−1.87 to −1.34) | <0.001 | 6 | 2014–2021 | −1.69 (−1.89 to −1.48) | <0.001 | 6 | 2015–2021 | −1.81 (−2.19 to −1.44) | <0.001 | |
| IS | 1 | 1990–1998 | 0.61 (0.39 to 0.84) | <0.001 | 1 | 1990–1997 | 0.27 (−0.07 to 0.62) | 0.115 | 1 | 1990–1999 | 0.97 (0.74 to 1.21) | <0.001 |
| 2 | 1998–2004 | 3.55 (3.10 to 3.99) | <0.001 | 2 | 1997–2004 | 2.72 (2.31 to 3.14) | <0.001 | 2 | 1999–2004 | 5.03 (4.25 to 5.82) | <0.001 | |
| 3 | 2004–2007 | −4.25 (−5.95 to −2.51) | <0.001 | 3 | 2004–2007 | −5.06 (−7.18 to −2.89) | 0 | 3 | 2004–2007 | −3.31 (−5.51 to −1.06) | 0.007 | |
| 4 | 2007–2010 | 1.20 (−0.59 to 3.02) | 0.175 | 4 | 2007–2010 | 0.05 (−2.18 to 2.33) | 0.964 | 4 | 2007–2010 | 1.92 (−0.31 to 4.20) | 0.087 | |
| 5 | 2010–2015 | −2.20 (−2.75 to −1.64) | <0.001 | 5 | 2010–2014 | −3.38 (−4.52 to −2.24) | <0.001 | 5 | 2010–2019 | −1.59 (−1.83 to −1.35) | <0.001 | |
| 6 | 2015–2021 | −1.01 (−1.35 to −0.68) | <0.001 | 6 | 2014–2021 | −0.94 (−1.28 to −0.60) | <0.001 | 6 | 2019–2021 | −0.37 (−2.78 to 2.10) | 0.75 | |
| ICH | 1 | 1990–1998 | −0.57 (−0.76 to −0.37) | <0.001 | 1 | 1990–1997 | −1.26 (−1.50 to −1.02) | <0.001 | 1 | 1990–1998 | −0.15 (−0.44 to 0.14) | 0.28 |
| 2 | 1998–2004 | 2.16 (1.79 to 2.54) | <0.001 | 2 | 1997–2004 | 1.40 (1.11 to 1.69) | <0.001 | 2 | 1998–2004 | 2.87 (2.31 to 3.43) | <0.001 | |
| 3 | 2004–2007 | −5.86 (−7.32 to −4.37) | <0.001 | 3 | 2004–2007 | −6.77 (−8.19 to −5.32) | <0.001 | 3 | 2004–2007 | −4.72 (−6.94 to −2.45) | 0.001 | |
| 4 | 2007–2010 | −1.85 (−3.32 to −0.35) | 0.019 | 4 | 2007–2010 | −2.96 (−4.43 to −1.46) | 0.001 | 4 | 2007–2010 | −1.26 (−3.47 to 1.00) | 0.251 | |
| 5 | 2010–2015 | −5.13 (−5.59 to −4.67) | <0.001 | 5 | 2010–2015 | −5.91 (−6.38 to −5.44) | <0.001 | 5 | 2010–2015 | −4.64 (−5.30 to −3.97) | <0.001 | |
| 6 | 2015–2021 | −2.13 (−2.42 to −1.85) | <0.001 | 6 | 2015–2021 | −2.00 (−2.29 to −1.70) | <0.001 | 6 | 2015–2021 | −2.24 (−2.65 to −1.83) | <0.001 | |
| SAH | 1 | 1990–1995 | −0.97 (−1.57 to −0.36) | 0.004 | 1 | 1990–1995 | −1.30 (−2.10 to −0.50) | 0.004 | 1 | 1990–1995 | −0.49 (−1.43 to 0.45) | 0.283 |
| 2 | 1995–2000 | −6.25 (−7.03 to −5.47) | <0.001 | 2 | 1995–2000 | −7.28 (−8.24 to −6.31) | <0.001 | 2 | 1995–2000 | −5.11 (−6.34 to −3.87) | <0.001 | |
| 3 | 2000–2004 | −14.70 (−15.51 to −13.89) | <0.001 | 3 | 2000–2004 | −15.78 (−16.84 to −14.70) | <0.001 | 3 | 2000–2003 | −13.46 (−16.11 to −10.73) | <0.001 | |
| 4 | 2004–2007 | −9.84 (−11.28 to −8.38) | <0.001 | 4 | 2004–2007 | −10.44 (−12.57 to −8.26) | <0.001 | 4 | 2003–2006 | −11.49 (−13.52 to −9.40) | <0.001 | |
| 5 | 2007–2010 | −1.38 (−2.98 to 0.24) | 0.089 | 5 | 2007–2014 | −2.70 (−3.09 to −2.30) | <0.001 | 5 | 2006–2015 | −1.99 (−2.25 to −1.73) | <0.001 | |
| 6 | 2010–2021 | −2.14 (−2.26 to −2.02) | <0.001 | 6 | 2014–2021 | −0.87 (−1.23 to −0.52) | <0.001 | 6 | 2015–2021 | −3.10 (−3.55 to −2.65) | <0.001 | |
| APC – annual percentage change; CI – confidence interval; ICH – intracerebral hemorrhage; IS – ischemic stroke; SAH – subarachnoid hemorrhage. | ||||||||||||