Accelerating the transition from treatment-oriented to prevention-oriented stroke management_West China Medical Journal

Authors：

WANG Yanan , WU Simiao , WU Bo ,  LIU Ming

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIU Ming, Email: liuming201502@163.com

Keywords：

Stroke; full life cycle; prevention-oriented

DOI：

10.7507/1002-0179.202604276

Video：

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Stroke prevention and treatment in China have achieved significant progress in reducing the disease burden and controlling major risk factors. However, important challenges remain, including a growing number of stroke cases and the need to establish a comprehensive and efficient patient management system spanning the pre-hospital, in-hospital, and post-hospital phases. This article systematically reviews the current status and key issues in stroke prevention and control and proposes that greater emphasis should be placed on accelerating the transition from a “treatment-oriented” to a “prevention-oriented” approach in stroke management. It highlights the importance of building a full lifecycle health-care system for stroke prevention and care, enhancing the effectiveness of interventions through a tiered and coordinated care model, and promoting the deep integration of digital and intelligent technologies. These efforts may provide valuable guidance for clinical practice and support the achievement of the “Healthy China” goals.

Citation： WANG Yanan, WU Simiao, WU Bo, LIU Ming. Accelerating the transition from treatment-oriented to prevention-oriented stroke management. West China Medical Journal, 2026, 41(5): 705-709. doi: 10.7507/1002-0179.202604276 Copy

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2.	Liu M, Wu B, Wang WZ, et al. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol, 2007, 6(5): 456-464.
3.	Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
4.	中共中央, 國務院. 中共中央國務院印發《“健康中國 2030”規劃綱要》. 中華人民共和國國務院公報, 2016(32): 5-20.
5.	Wu S, Wang Y, Liu J, et al. Stroke in China: advances in prevention and management on the path to a healthy China. Lancet Neurol, 2026, 25(4): 379-395.
6.	Zhang M, Shi Y, Zhou B, et al. Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey. BMJ, 2023, 380: e071952.
7.	Lu Y, Zhang H, Lu J, et al. Prevalence of dyslipidemia and availability of lipid-lowering medications among primary health care settings in China. JAMA Netw Open, 2021, 4(9): e2127573.
8.	Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013-2018. JAMA, 2021, 326(24): 2498-2506.
9.	中國營養學會. 中國居民膳食指南(2022). 北京: 中國營養學會, 2022.
10.	Fang Y, Xia J, Lian Y, et al. The burden of cardiovascular disease attributable to dietary risk factors in the provinces of China, 2002-2018: a nationwide population-based study. Lancet Reg Health West Pac, 2023, 37: 100784.
11.	Zhang M, Yang L, Wang L, et al. Trends in smoking prevalence in urban and rural China, 2007 to 2018: Findings from 5 consecutive nationally representative cross-sectional surveys. PLoS Med, 2022, 19(8): e1004064.
12.	Millwood IY, Im PK, Bennett D, et al. Alcohol intake and cause-specific mortality: conventional and genetic evidence in a prospective cohort study of 512 000 adults in China. Lancet Public Health, 2023, 8(12): e956-e967.
13.	Nakada S, Ho FK, Celis-Morales C, et al. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: a UK Biobank prospective cohort study. Eur Psychiatry, 2023, 66(1): e54.
14.	Meng R, Yu C, Liu N, et al. Association of depression with all-cause and cardiovascular disease mortality among adults in China. JAMA Netw Open, 2020, 3(2): e1921043.
15.	Wang CJ, Gu HQ, Zhang XM, et al. Temporal trends and rural-urban disparities in cerebrovascular risk factors, in-hospital management and outcomes in ischaemic strokes in China from 2005 to 2015: a nationwide serial cross-sectional survey. Stroke Vasc Neurol, 2023, 8(1): 34-50.
16.	Pan Y, Li Z, Li J, et al. Residual risk and its risk factors for ischemic stroke with adherence to guideline-based secondary stroke prevention. J Stroke, 2021, 23(1): 51-60.
17.	趙曉玲, 劉鳴. 卒中的預防——證據與實踐的差距有待縮小. 國外醫學腦血管疾病分冊, 2002, 10(3): 185-187.
18.	張思瑋. 劉鳴: 腦卒中預防獲益遠大于治療. 醫學科學報, 2024-10-18(3).
19.	林敬, 楊梅, 劉鳴. 從患者和大眾角度開展腦卒中防治的實效性科普宣教工作. 中華全科醫師雜志, 2019, 18(2): 193-195.
20.	郭文, 吳思緲, 劉鳴. 提倡強化危重癥腦梗死分類分期預防意識. 華西醫學, 2021, 36(6): 701-706.
21.	吳思緲, 袁若圳, 劉鳴. 應當提倡大面積腦梗死后惡性腦水腫的預防理念及其研究. 中華神經科雜志, 2020, 53(4): 244-249.
22.	Wu S, Anderson CS. Antiplatelets for secondary stroke prevention in China. Lancet Neurol, 2023, 22(6): 457-459.
23.	寇為民, 華星, 何昊洋, 等. 急性缺血性腦卒中抗栓治療的藥物相互作用機制與臨床挑戰. 中風與神經疾病雜志, 2026, 43(3): 204-213.
24.	Wu S, Anderson CS. Healthy eating for secondary stroke prevention. Lancet Neurol, 2021, 20(2): 87-89.
25.	Wu S, Anderson CS. A need to re-focus efforts to improve long-term prognosis after stroke in China. Lancet Glob Health, 2020, 8(4): e468-e469.
26.	Gao Y, Li Z, Zhai X, et al. MRI-based habitat radiomics combined with vision transformer for identifying vulnerable intracranial atherosclerotic plaques and predicting stroke events: a multicenter, retrospective study. EClinicalMedicine, 2025, 82: 103186.
27.	Nagaratnam K, Neuhaus AA, Fensome L, et al. Artificial intelligence imaging decision support for acute stroke treatment in England: a prospective observational study. Lancet Digit Health, 2025, 7(12): 100927.
28.	Labovitz DL, Shafner L, Reyes Gil M, et al. Using artificial intelligence to reduce the risk of nonadherence in patients on anticoagulation therapy. Stroke, 2017, 48(5): 1416-1419.
29.	Zhang B, Wong KP, Liu M, et al. Effect of artificial intelligence-based video-game system on dysphagia in patients with stroke: a randomized controlled trial. Clin Nutr, 2025, 45: 81-90.
30.	Tan J, Gong E, Gallis JA, et al. Primary care-based digital health-enabled stroke management intervention: long-term follow-up of a cluster randomized clinical trial. JAMA Netw Open, 2024, 7(12): e2449561.
31.	劉鳴, 宋心迪, 王亞楠. 從循證臨床決策角度看人工智能應用的相關問題. 華西醫學, 2025, 40(5): 685-688.

1. Wu S, Liu M. Global burden of stroke: dynamic estimates to inform action. Lancet Neurol, 2024, 23(10): 952-953.
2. Liu M, Wu B, Wang WZ, et al. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol, 2007, 6(5): 456-464.
3. Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
4. 中共中央, 國務院. 中共中央國務院印發《“健康中國 2030”規劃綱要》. 中華人民共和國國務院公報, 2016(32): 5-20.
5. Wu S, Wang Y, Liu J, et al. Stroke in China: advances in prevention and management on the path to a healthy China. Lancet Neurol, 2026, 25(4): 379-395.
6. Zhang M, Shi Y, Zhou B, et al. Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey. BMJ, 2023, 380: e071952.
7. Lu Y, Zhang H, Lu J, et al. Prevalence of dyslipidemia and availability of lipid-lowering medications among primary health care settings in China. JAMA Netw Open, 2021, 4(9): e2127573.
8. Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013-2018. JAMA, 2021, 326(24): 2498-2506.
9. 中國營養學會. 中國居民膳食指南(2022). 北京: 中國營養學會, 2022.
10. Fang Y, Xia J, Lian Y, et al. The burden of cardiovascular disease attributable to dietary risk factors in the provinces of China, 2002-2018: a nationwide population-based study. Lancet Reg Health West Pac, 2023, 37: 100784.
11. Zhang M, Yang L, Wang L, et al. Trends in smoking prevalence in urban and rural China, 2007 to 2018: Findings from 5 consecutive nationally representative cross-sectional surveys. PLoS Med, 2022, 19(8): e1004064.
12. Millwood IY, Im PK, Bennett D, et al. Alcohol intake and cause-specific mortality: conventional and genetic evidence in a prospective cohort study of 512 000 adults in China. Lancet Public Health, 2023, 8(12): e956-e967.
13. Nakada S, Ho FK, Celis-Morales C, et al. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: a UK Biobank prospective cohort study. Eur Psychiatry, 2023, 66(1): e54.
14. Meng R, Yu C, Liu N, et al. Association of depression with all-cause and cardiovascular disease mortality among adults in China. JAMA Netw Open, 2020, 3(2): e1921043.
15. Wang CJ, Gu HQ, Zhang XM, et al. Temporal trends and rural-urban disparities in cerebrovascular risk factors, in-hospital management and outcomes in ischaemic strokes in China from 2005 to 2015: a nationwide serial cross-sectional survey. Stroke Vasc Neurol, 2023, 8(1): 34-50.
16. Pan Y, Li Z, Li J, et al. Residual risk and its risk factors for ischemic stroke with adherence to guideline-based secondary stroke prevention. J Stroke, 2021, 23(1): 51-60.
17. 趙曉玲, 劉鳴. 卒中的預防——證據與實踐的差距有待縮小. 國外醫學腦血管疾病分冊, 2002, 10(3): 185-187.
18. 張思瑋. 劉鳴: 腦卒中預防獲益遠大于治療. 醫學科學報, 2024-10-18(3).
19. 林敬, 楊梅, 劉鳴. 從患者和大眾角度開展腦卒中防治的實效性科普宣教工作. 中華全科醫師雜志, 2019, 18(2): 193-195.
20. 郭文, 吳思緲, 劉鳴. 提倡強化危重癥腦梗死分類分期預防意識. 華西醫學, 2021, 36(6): 701-706.
21. 吳思緲, 袁若圳, 劉鳴. 應當提倡大面積腦梗死后惡性腦水腫的預防理念及其研究. 中華神經科雜志, 2020, 53(4): 244-249.
22. Wu S, Anderson CS. Antiplatelets for secondary stroke prevention in China. Lancet Neurol, 2023, 22(6): 457-459.
23. 寇為民, 華星, 何昊洋, 等. 急性缺血性腦卒中抗栓治療的藥物相互作用機制與臨床挑戰. 中風與神經疾病雜志, 2026, 43(3): 204-213.
24. Wu S, Anderson CS. Healthy eating for secondary stroke prevention. Lancet Neurol, 2021, 20(2): 87-89.
25. Wu S, Anderson CS. A need to re-focus efforts to improve long-term prognosis after stroke in China. Lancet Glob Health, 2020, 8(4): e468-e469.
26. Gao Y, Li Z, Zhai X, et al. MRI-based habitat radiomics combined with vision transformer for identifying vulnerable intracranial atherosclerotic plaques and predicting stroke events: a multicenter, retrospective study. EClinicalMedicine, 2025, 82: 103186.
27. Nagaratnam K, Neuhaus AA, Fensome L, et al. Artificial intelligence imaging decision support for acute stroke treatment in England: a prospective observational study. Lancet Digit Health, 2025, 7(12): 100927.
28. Labovitz DL, Shafner L, Reyes Gil M, et al. Using artificial intelligence to reduce the risk of nonadherence in patients on anticoagulation therapy. Stroke, 2017, 48(5): 1416-1419.
29. Zhang B, Wong KP, Liu M, et al. Effect of artificial intelligence-based video-game system on dysphagia in patients with stroke: a randomized controlled trial. Clin Nutr, 2025, 45: 81-90.
30. Tan J, Gong E, Gallis JA, et al. Primary care-based digital health-enabled stroke management intervention: long-term follow-up of a cluster randomized clinical trial. JAMA Netw Open, 2024, 7(12): e2449561.
31. 劉鳴, 宋心迪, 王亞楠. 從循證臨床決策角度看人工智能應用的相關問題. 華西醫學, 2025, 40(5): 685-688.

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