Premature ischemic stroke mortality in China to 2030: age- and sex-specific trends and projections.

Background

Age-specific evidence is needed to describe premature ischemic stroke mortality in China and to support transparent surveillance through 2030.

Methods

We analyzed GBD 2023 estimates for China from 1990 to 2023 in eight five-year age groups from 30-34 to 65-69 years. Age-specific mortality rates were the primary outcomes. Temporal trends were estimated with log-linear segmented regression. Candidate ARIMA models were compared using rolling-origin validation, information criteria, and residual diagnostics. A 30-69-year study-specific normalized weighted mortality rate was retained only as a secondary sensitivity analysis.

Results

Mortality rates declined across all eight age groups for males, females, and both sexes. In 2023, both-sex rates ranged from 0.44 per 100,000 in ages 30-34 years to 100.03 per 100,000 in ages 65-69 years. Age-specific 2030 forecasts ranged from 0.10 to 35.09 per 100,000 for females and from 0.46 to 107.67 per 100,000 for males. Under the secondary project-existing weighting scheme, the 2030 composite forecasts were 17.46 (95% prediction interval 7.92-27.00) per 100,000 for males, 5.47 (2.34-8.60) for females, and 11.80 (6.64-16.96) for both sexes. These composite estimates are not official GBD age-standardized rates.

Conclusions

The primary evidence shows substantial age heterogeneity and consistently higher male rates. Conditional forecasts support continued age- and sex-specific surveillance, but they do not establish causal mechanisms, intervention effects, or policy-target attainment.