天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (7): 771-778.doi: 10.11958/20253377

• 流行病学调查 • 上一篇    下一篇

1990—2023年中国老年人群高收缩压导致脑出血的疾病负担趋势及年龄-时期-队列模型分析

张越洋1(), 周震2,△(), 赵志恒2, 徐家淳2, 任月乔1, 张胤弢1   

  1. 1 天津中医药大学研究生院 （邮编301617）
    2 天津中医药大学第二附属医院脑病针灸中心
  • 收稿日期:2025-11-19 修回日期:2026-01-28 出版日期:2026-07-15 发布日期:2026-07-13
  • 通讯作者: △E-mail：zhouzhen7681@126.com
  • 作者简介:张越洋（1998），男，博士在读，主要从事中风后遗症的针灸临床与基础研究。E-mail：zhangyueyangTCM@163.com
  • 基金资助:
    天津市卫生健康委员会中医中西医结合科研课题(2025066)

Analysis of the disease burden trend of intracerebral hemorrhage caused by high systolic blood pressure in elderly population of China from 1990 to 2023 and the age-period-cohort model

ZHANG Yueyang1(), ZHOU Zhen2,△(), ZHAO Zhiheng2, XU Jiachun2, REN Yueqiao1, ZHANG Yintao1   

  1. 1 Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
    2 Encephalopathy and Acupuncture Center, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine
  • Received:2025-11-19 Revised:2026-01-28 Published:2026-07-15 Online:2026-07-13
  • Contact: △E-mail：zhouzhen7681@126.com

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摘要：

目的 系统分析1990—2023年中国≥65岁老年人群归因于高收缩压的脑出血（ICH）疾病负担趋势，运用年龄-时期-队列（APC）模型揭示死亡风险和疾病负担的独立效应，并对2024—2040年中国归因于高收缩压ICH疾病负担进行预测。方法 基于2023年全球疾病负担（GBD）数据，提取中国老年人群高收缩压所致ICH的死亡和伤残调整寿命年（DALYs）数据。构建APC模型，将研究对象分别依次分为年龄组（7个）、时期组（7个）和出生队列组（13个），分析年龄、时期和出生队列对死亡率和DALYs率的相对危险度（RR）。使用贝叶斯年龄-时期-队列（BAPC）模型预测2024—2040年中国因高收缩压导致ICH患者年龄标化的死亡率（ASMR）和DALYs率（ASDR）。结果 2023年，中国老年人群因高收缩压导致ICH的死亡数为518 845例，较1990年增长8.25%；DALYs数降低3.39%。然而，ASMR和ASDR分别下降70.30%和71.42%，平均年度变化百分比（AAPC）分别为-3.50%和-3.62%。APC模型显示，死亡和DALYs风险随年龄增长呈先上升后下降趋势，死亡风险峰值在90~94岁，DALYs峰值在75~79岁。时期效应表明，死亡和DALYs风险在2009年后持续下降。队列效应呈现代际改善趋势，越晚出生的队列，死亡和DALYs风险越低。男性死亡和DALYs绝对数及标化率增幅均高于女性，女性绝对数及标化率降幅更为显著。BAPC模型预测结果显示，至2040年，中国因高收缩压导致ICH的ASMR和ASDR将分别下降至121.4/10万和1 777.9/10万。结论 1990—2023年间，中国老年人群因高收缩压所致的ICH疾病负担呈相对下降趋势，但人口老龄化使其绝对负担持续加重，未来需重点针对高龄老年人和合并高血压的男性群体开展血压与脑血管风险的双重干预。

关键词: 中国, 死亡率, 颅内出血, 高血压性, 全球疾病负担, 伤残调整寿命年, 年龄-时期-队列模型

Abstract:

Objective To systematically analyze the trends in disease burden of intracerebral hemorrhage (ICH) attributed to high systolic blood pressure among the elderly population aged ≥65 years in China from 1990 to 2023, apply the age-period-cohort (APC) model to reveal the independent effects of death risk and disease burden, and predict the disease burden of ICH attributed to high systolic blood pressure in China from 2024 to 2040. Methods Based on the data from the 2023 Global Burden of Disease (GBD) study, this study extracted the mortality and Disability-Adjusted Life Years (DALYs) data of ICH caused by high systolic blood pressure in elderly population in China. An APC model was constructed, and the study subjects were divided into 7 age groups, 7 period groups and 13 birth cohort groups. The relative risks (RR) of age, period and birth cohort on the mortality rate and DALYs rate were analyzed. The Bayesian age-period-cohort (BAPC) model was employed to forecast the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) of ICH patients caused by high systolic blood pressure in China from 2024 to 2040. Results In 2023, the number of death from ICH attributable to high systolic blood pressure in elderly population in China reached 518 845 cases, representing an increase of 8.25% compared with 1990, while DALYs decreased by 3.39%. However, the ASMR and ASDR decreased by 70.30% and 71.42%, respectively, with average annual percentage changes (AAPC) of -3.50% and -3.62%. The APC model indicated that the mortality and DALYs risk showed an initial increase and then decreased with age. The peak risk of death was between 90-94 years old, and the peak risk of DALYs was between 75-79 years old. The period effect demonstrated a sustained decline in mortality and DALYs risk from 2009. The cohort effect revealed an intergenerational improvement trend, with later-born cohorts exhibiting lower mortality and DALYs risk. The increase in the absolute number of death and the standardised rate of DALYs were increased in male than those in female, and the decrease in the absolute number and standardized rate were more significant in female. The prediction results of the BAPC model indicated that by 2040, the ASMR and ASDR of ICH in China due to high systolic blood pressure would decrease to 121.4 per 100 000 and 1 777.9 per 100 000, respectively. Conclusion From 1990 to 2023, the disease burden of ICH attributable to high systolic blood pressure in elderly population in China shows a relatively downward trend, while the aging of the population continuously increased its absolute burden. In the future, it is necessary to focus on the dual intervention of blood pressure and cerebrovascular risk for the elderly and male with hypertension.

Key words: China, mortality, intracranial hemorrhage, hypertensive, global burden of disease, disability-adjusted life years, age-period-cohort model

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