To analyze the disease burden of stroke due to high systolic blood pressure and its trend in residents aged 75 years and above in China.

Data from the Global Burden of Disease Study 2019 (GBD 2019) were collected and Joinpoint regression model was used to analyze the mortality rate and disability-adjusted life year (DALY) of stroke due to high systolic blood pressure in elderly people aged 75 years and above in China from 1990 to 2019.

From 1990 to 2019, the number of stroke deaths due to high systolic blood pressure in residents aged 75 years and above increased from 221 019 to 552 179, but the crude death rate and DALY rate declined from 806.84/10⁵ and 10 694.21/10⁵ to 611.01/10⁵ and 7 967.83/10⁵, respectively. Trend analysis found that the crude stroke mortality rate due to high systolic blood pressure among residents aged 75 years and above in China decreased by 0.86% per year, with 0.36% per year in men and 1.38% per year in women (Z=-6.72, -3.08, -9.43; P < 0.01); and the DALY rate decreased by 0.88% per year, with 0.45% per year in men and 1.33% per year in women (Z=-7.16, -3.88, -9.91; P < 0.01). Crude mortality and DALY rates for stroke due to hypertension were higher in residents aged 75 years and above compared with those between 65-<75 years old, and the DALY rate in residents aged 75 years and above decline at a lower rate (-0.88% and -1.24%, respectively). The DALY rate of stroke due to high systolic blood pressure among residents aged 75 years and above in China was higher than that of high, medium, and low social demographic index (SDI) countries or regions, and the percentage of year-on-year decline was lower than that of high SDI countries or regions, but higher than that of medium and low SDI countries or regions (China: -0.88%, high SDI countries or regions: -3.57%, medium SDI countries or regions: -0.69%, low SDI countries or regions: -0.67%).

The disease burden of stroke due to high systolic blood pressure in China's elderly is high and slow to decline, and research on precise health management of the elderly risk group should be carried out in depth to achieve the goal of healthy aging.