Time trend analysis of ischemic stroke mortality in Tengzhou City of Shandong Province from 2013 to 2021
Objective Analyze the temporal trend of ischemic stroke(IS)mortality among the residents of Tengzhou City of Shandong Province during the period of hypertension control from 2013 to 2021.Methods On January 1,2013,Tengzhou City,Shandong Province,began its hypertension control program.The IS mortality rate was calculated using the mortality data from January 1,2013 to December 31,2021,and analyzed for its time trend among residents with different characteristics.The registered population was derived from the Public Security Bureau of Tengzhou City,Shandong Province,and the age and sex standardized mortality rate was calculated using the data of China's 7th population census in 2020.The Chi-square test was used to compare the differences in mortality rate,and Cochran-Armitage trend test was used to compare the time trend and age trend of mortality rate.Results The overall crude and standardized mortality rates of IS in Tengzhou showed a temporal trend from 2013 to 2021(Z values were 12.647,7.305,respectively;all P<0.001),and decreased by 23.77%and 30.99%(Z values were-7.393,-9.975,respectively;all P<0.001)respectively in 2021 compared with 2019.The crude mortality rate of IS in male increased by 13.27%in 2019 compared with 2017,while the crude and standardized mortality rate in female decreased by 16.39%and 19.49%in 2018 compared with 2017,respectively,with statistical significance(x2 values were 7.160,9.789,and 15.109,respectively;all P<0.05).Except the crude mortality rates in 2013 and 2015,the crude mortality rates and standardized mortality rates for males in other years were all higher than those for females,with statistically significant differences(x2 values:25.816-124.040,all P<0.001).The crude mortality rate for IS increased with age in all years(Z values:42.604-61.025,all P<0.001).The proportion of IS deaths among those aged≥65 was 85.85%.The overall crude mortality rates of the age group of male 45-54 years old showed a temporal trend from 2013 to 2021(Z=3.035,P<0.01),while females in the same age group did not show a temporal trend(P>0.05).The IS mortality rate in urban areas decreased from 62.61 per 100 000 in 2013 to 54.00 per 100 000 in 2021(Z=-2.097,P<0.05).The rural areas increased by 213.15%in 2019 compared with 2013 and decreased by 22.75%in 2021 compared with 2019(Z values were 19.074,-6.390,respectively;all P<0.001).Conclusions The IS mortality rate in Tengzhou City showed a decreasing trend in urban areas from 2013 to 2021,and a decreasing trend in rural areas after 2019.Compared to females,there is a trend of younger mortality among males in the age range of 45-54.Males and rural IS patients should be given special attention.
Ischemic strokeMortality rateEpidemiological study