Review ArticlesA Systematic Literature Review of Risk Factors for Stroke in ChinaYong, Huo MD*; Foody, JoAnne MD†; Linong, Ji MD‡; Dong, Zhao MD§; Wang, Yongjun MD¶; Ma, Li PhD‖; Meng, Hai Jin MD, PhD**; Shiff, Susan PhD, MBA††; Dayi, Hu MD‡‡Author Information From the *Department of Cardiology, Peking University First Hospital, Beijing, China; †Cardiovascular Wellness Program, Brigham & Women’s Hospital, Boston, MA; ‡Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China; §Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; ¶Neurology Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; ‖ United BioSource Corporation, Bethesda, MD; **Pfizer Investment Co., Ltd., Beijing, China; ††Pfizer Inc, New York, NY; and ‡‡Chief, Heart Center, People Hospital of Peking University, President, Chinese Society of Cardiology, Beijing, China. Disclosure: Dr. JoAnne Foody is a Pfizer Inc. consultant. Dr. Li Ma was an employee of United BioSource Corporation at the time this systematic review was conducted and this manuscript developed. Dr. Hai Jin Meng is an employee of Pfizer, Ltd. Dr. Susan Shiff is a Pfizer Inc. medical employee and is also an owner of Pfizer stock. The remaining authors declare no conflict of interest. Supported by Pfizer Inc. Emerging Markets Outcomes Research and Epidemiology. The principal investigators and co-investigators had full access to the data and were responsible for the study protocol, study progress, analysis, study reporting, and decision to publish the paper. Pfizer Inc. had the opportunity to comment on the manuscript before submission. Correspondence: Susan Shiff, PhD, MBA, Outcomes Research and Epidemiology, Emerging Markets, Established Products, and Biosimilars Pfizer Inc, 235 East 42nd Street, New York, NY 10017. E-mail: [email protected]. Cardiology in Review: March/April 2013 - Volume 21 - Issue 2 - p 77-93 doi: 10.1097/CRD.0b013e3182748d37 Buy Metrics Abstract Other countries have seen a decline in stroke incidence after improved treatment and prevention of known risk factors for stroke. China is still experiencing significant increases in the incidence rate of total stroke. We systematically reviewed the evidence on the impact of 5 modifiable risk factors (hypertension, dyslipidemia, obesity, diabetes, and smoking) for the risk of stroke in the Chinese population, with the aim to develop more effective prevention and disease management programs. A literature search was conducted in MEDLINE and EMBASE for all observational studies that reported on the association between risk of stroke and any of the 5 risk factors and the composite risk factor. Selected articles were published in either English or Chinese from January 2004 to December 2010. Evidence of the association between hypertension and stroke was the strongest of the 5 factors reported in studies, with adjusted odds ratios ranging between 2.75 and 5.47. The association among obesity, diabetes, smoking, and the risk for stroke was evident, but not as strong as for hypertension. The risk ratios of hypertension to stroke were higher in the Chinese population than those in other countries. © 2013 Lippincott Williams & Wilkins, Inc.