With over 2 million new cases annually, stroke is associated with the highest disability-adjusted life-years lost of any disease in China. The burden is expected to increase further as a result of population ageing, an ongoing high prevalence of risk factors (eg, hypertension), and inadequate management. Despite improved access to overall health services, the availability of specialist stroke care is variable across the country, and especially uneven in rural areas. In-hospital outcomes have improved because of a greater availability of reperfusion therapies and supportive care, but adherence to secondary prevention strategies and long-term care are inadequate. Thrombolysis and stroke units are accepted as standards of care across the world, including in China, but bleeding-risk concerns and organisational challenges hamper widespread adoption of this care in China. Despite little supporting evidence, Chinese herbal products and neuroprotective drugs are widely used, and the increased availability of neuroimaging techniques also results in overdiagnosis and overtreatment of so-called silent stroke. Future efforts should focus on providing more balanced availability of specialised stroke services across the country, enhancing evidence-based practice, and encouraging greater translational research to improve outcome of patients with stroke.
[1]Sichuan Univ, West China Hosp, Dept Neurol, Chengdu 610041, Sichuan, Peoples R China.
[2]Sichuan Univ, West China Hosp, Ctr Cerebrovasc Dis, Chengdu, Sichuan, Peoples R China.
[3]Sichuan Univ, West China Hosp, State Key Lab Biotherapy, Chengdu, Sichuan, Peoples R China.
[4]Univ Oxford, Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Oxford, England.
[5]Univ Oxford, Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Oxford, England.
[6]Capital Med Univ, Beijing Neurosurg Inst, Dept Neuroepidemiol, Beijing, Peoples R China.
[7]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China.
[8]Capital Med Univ, Xuan Wu Hosp, Dept Neurol, Innovat Ctr Neurol Disorders, Beijing, Peoples R China.
[9]Capital Med Univ, Fac Rehabil Med, Beijing, Peoples R China.
[10]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China.
[11]China Rehabil Res Ctr, Neurorehabil Dept, Beijing, Peoples R China.
[12]Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia.
[13]Peking Univ, Hlth Sci Ctr, George Inst China, Beijing, Peoples R China.
[14]Royal Prince Alfred Hosp, Dept Neurol, Sydney, NSW, Australia.
[15]Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland.
[16]Peking Univ, Hosp 1, Dept Neurol, Beijing, Peoples R China.
[17]Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Neurol, Beijing, Peoples R China.
[18]Chinese Peoples Liberat Army Gen Hosp, Dept Neurol, Beijing, Peoples R China.
[19]Nanjing Univ, Jinling Hosp, Sch Med, Dept Neurol, Nanjing, Jiangsu, Peoples R China.
[20]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Neurol, Wuhan, Hubei, Peoples R China.
[21]Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China.
[22]Peking Univ, Hosp 3, Dept Neurol, Beijing, Peoples R China.
[23]Peking Univ, Natl Hlth Commiss, Minist Educ, Key Lab Neurosci, Beijing, Peoples R China.
[24]Chinese Univ Hong Kong, Dept Med & Therapeut, Div Neurol, Hong Kong, Peoples R China.
[25]Natl Hlth Commiss Peoples Republ China, Stroke Prevent Project Comm, Beijing, Peoples R China.
[26]Cent South Univ, Xiangya Hosp, Dept Neurol, Changsha, Hunan, Peoples R China.
[27]Tianjin Med Univ, Hosp 2, Dept Neurol, Tianjin, Peoples R China.
[28]Fudan Univ, Huashan Hosp, Dept Neurol, Shanghai, Peoples R China.
[29]Sun Yat Sen Univ, Affiliated Hosp 1, Dept Neurol, Guangzhou, Guangdong, Peoples R China.
[30]Sun Yat Sen Univ, Affiliated Hosp 1, Stroke Ctr, Guangzhou, Guangdong, Peoples R China.
[31]Nanjing Univ, Sch Med, Affiliated Drum Tower Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China.
[32]Jilin Univ, Hosp 1, Dept Neurol, Changchun, Jilin, Peoples R China.
[33]Fourth Mil Med Univ, Xijing Hosp, Dept Neurol, Xian, Shaanxi, Peoples R China.
[34]Zhengzhou Univ, Dept Neurol, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China.
[35]Third Mil Med Univ, Xinqiao Hosp, Dept Neurol, Chongqing, Peoples R China.
[36]China Med Univ, Affiliated Hosp 1, Dept Neurol, Shenyang, Liaoning, Peoples R China.
[37]Tongji Univ, Shanghai 4 Peoples Hosp, Dept Neurol, Shanghai, Peoples R China.
[38]Sichuan Univ, West China Hosp, Dept Neurosurg, Chengdu, Sichuan, Peoples R China.
[39]Beijing Univ Chinese Med, Dongzhimen Hosp, Dept Neurol, Beijing, Peoples R China.
[40]Chengdu Med Coll, Dept Neurol, Affiliated Hosp 1, Chengdu, Sichuan, Peoples R China.
[41]Chengdu Med Coll, Stroke Ctr, Affiliated Hosp 1, Chengdu, Sichuan, Peoples R China.
[42]Nanjing Med Univ, Nanjing Hosp 1, Dept Neurol, Nanjing, Jiangsu, Peoples R China.
[43]Nanjing Med Univ, Nanjing Hosp 1, Stroke Ctr, Nanjing, Jiangsu, Peoples R China.
[44]Kunming Med Univ, Affiliated Hosp 1, Dept Neurol, Kunming, Yunnan, Peoples R China.
[45]Peoples Hosp Tibet Autonomous Reg, Lhasa, Peoples R China.
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