Change in stroke incidence from a population-based intervention trial in three urban communities in China

被引:32
作者
Wang, Wen-Zhi
Jiang, Bin
Wu, Sheng-Ping
Hong, Zhen
Yang, Dong
Sander, J. W.
Du, Xiao-Li
Bao, Qiu-Jiu
机构
[1] Capital Med Univ, Beijing Neurosurg Inst, Dept Neuroepidemiol, Beijing 100050, Peoples R China
[2] Shanghai Fudan Univ, Inst Neurol, Dept Epidemiol, Shanghai, Peoples R China
[3] Zhongnan Univ, Xiangya Hosp, Dept Neurol, Changsha, Peoples R China
[4] UCL, Inst Neurol, London, England
关键词
stroke incidence; stroke; primary prevention; population based intervention trial;
D O I
10.1159/000103268
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 [公共卫生与预防医学]; 120402 [社会医学与卫生事业管理];
摘要
Stroke has been the main cause of death in most urban residents in China since the 1990s. A community-based intervention trial carried out in China aimed to reduce the incidence and mortality of stroke. In 1991, two well-matched communities each with approximately 50,000 people were selected as intervention or control communities in the urban areas of Beijing, Shanghai and Changsha. Regular health education and health promotion activities were carried out between 1991 and 2000 in the intervention communities but no special action was taken in the control communities. Both fatal and nonfatal stroke cases were meticulously registered during the study in the two communities to assess the effect of long-term intervention. The trend in stroke incidence and the effect of intervention on stroke incidence were analyzed using a Poisson regression model adjusted for age, sex, year and city. Between 1991 and 2000, 2,273 first-ever stroke cases were registered in the intervention communities and 3,015 in the control communities. Geographic variation and changes in the incidence of stroke and its subtypes were found among these 3 cities. Through 10 years of intervention, incidence risks of all, ischemic and hemorrhagic strokes decreased by 11.4% ( relative risk 0.8959; 95% confidence interval, CI, 0.8483-0.9460; p < 0.0001), 13.2% ( relative risk 0.8676; 95% CI 0.8054-0.9345; p = 0.0002) and 7.2% ( relative risk 0.9283; 95% CI 0.8517-1.0117; p = 0.0899), respectively, in the intervention compared with control communities. Accordingly, comprehensive community-based intervention measures could effectively reduce the incidence of stroke in the population. Copyright c 2007 S. Karger AG, Basel.
引用
收藏
页码:155 / 161
页数:7
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