Epidemiological Transition of Stroke in China?

See related article, pages 1668–1674. Results from the long-term surveillance of stroke as part of the Sino-MONICA project in Beijing, published in this month’s issue of Stroke , show marked changes in both stroke incidence and stroke subtypes.1 The authors conclude that characteristics of the stroke transition found over 2 decades and which reflected a period of economic development is in line with the theory of the epidemiological transition.2 According to this theory, with economic and social development, the disease pattern in a population shifts from a predominance of nutritional deficiencies and infectious diseases to chronic, noncommunicable diseases such as cardiovascular disease, diabetes, and cancers. A first step in the transition is associated with an increasing disease burden related to hypertension such as hemorrhagic stroke, whereas ischemic heart disease and ischemic stroke emerge at later stages in the transition. China and other Asian countries appear to be in the midstage of the transition supported by studies reporting higher hemorrhagic stroke rates compared with …