The Burden of Stroke in Pakistan

2008 ◽  
Vol 3 (4) ◽  
pp. 293-296 ◽  
Author(s):  
Bhojo A. Khealani ◽  
Mohammad Wasay
Keyword(s):  
Risk Factors ◽  
Stroke Risk ◽  
Case Series ◽  
Stroke Care ◽  
Poor Control ◽  
Stroke Incidence ◽  
Treatment Practices ◽  
Stroke Risk Factors ◽  
The Subject ◽  
Artery Disease

Epidemiologic literature on stroke burden, patterns of stroke is almost non existent from Pakistan. However, several hospital-based case series on the subject are available, mainly published in local medical journals. Despite the fact that true stroke incidence and prevalence of stroke in Pakistan is not known, the burden is assumed to be high because of highly prevalent stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, dyslipidemia and smoking) in the community. High burden of these conventional stroke risk factors is further compounded by lack of awareness, poor compliance hence poor control, and inappropriate management/treatment practices. In addition certain risk factors like rheumatic valvular heart disease may be more prevalent in Pakistan. We reviewed the existing literature on stroke risk factors in community, the risk factor prevalence among stroke patients, patterns of stroke, out come of stroke, availability of diagnostic services/facilities related to stroke and resources for stroke care in Pakistan.

Abstract P602: Stroke Risk Factors Among the Young Over Time in the GCNKSS

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Kathleen S Alwell ◽  
Opeolu M Adeoye ◽  
Felipe De Los Rios La Rosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Large Population ◽  
High Cholesterol ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
Obesity And Diabetes ◽  
Trends Over Time ◽  
Over Time

Background: Data from the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) have demonstrated stable or increasing stroke incidence rates in young adults with differences by sex and race, suggesting the need for targeted approaches to stroke prevention in the young. We aimed to describe trends over time in prevalence of stroke risk factors among adults ages 20-54 with stroke by sex and race. Methods: Cases of incident stroke (IS, ICH, SAH) occurring in those 20-54 years old and living in a 5-county area of southern Ohio/northern Kentucky were ascertained during 5 study periods (1993-1994, 1999, 2005, 2010, 2015). All physician-adjudicated inpatient events and a sampling of outpatient events were included, excluding nursing home events. Data on risk factors (hypertension, diabetes, obesity (BMI≥30), and high cholesterol) diagnosed prior to stroke were abstracted from medical records, and prevalence of each risk factor was reported over time in race/sex groups. Trends over time were examined using the Cochran-Armitage test. Results: Over the 5 study periods, 1204 incident strokes were included; 49% were women, 33% were black, and mean age was 46 (SD 7) years. Premorbid hypertension increased over time in Black women (48% in 1993/4 to 76% in 2015, p=0.005) but not in any other race/sex group (all p>0.05). Premorbid high cholesterol increased significantly in all race/sex groups (Figure, all p<0.05) except for White men (p=0.06). There were no significant trends over time in pre-stroke diagnoses of diabetes or obesity in any of the race/sex groups (Figure). Conclusions: Among patients aged 20-54 with incident stroke in a large population-based study, the change in the prevalence of hypertension and high cholesterol differed by sex and race, while obesity and diabetes were stable over time in all race/sex groups. Future research is needed to address risk factor control at a population level and to understand the role of undiagnosed pre-stroke risk factors in the young.

Epidemiology and stroke risk factors

2017 ◽  
Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Stroke Risk ◽  
Relative Risk Reduction ◽  
Stroke Care ◽  
Modifiable Risk Factors ◽  
Comprehensive Review ◽  
Stroke Risk Factors ◽  
The United Kingdom ◽  
Numbers Needed To Treat

In this opening chapter on the epidemiology and risk factors for stroke, the ‘size of the problem’ in public health terms both in the United Kingdom and worldwide is set out. Incidence, prevalence, and mortality of stroke are discussed. Epidemiological terms and definitions as applied to stroke care are reviewed and illustrated, including absolute and relative risk reduction and numbers needed to treat. This chapter also discusses aetiological subtyping of stroke which represents a syndrome caused by multiple different underlying pathologies. It ends with a comprehensive review of the major and minor modifiable and non-modifiable risk factors for stroke disease.

scholarly journals PROFIL FAKTOR-FAKTOR RISIKO PADA PASIEN STROKE YANG DIRAWAT INAP DI IRINA F NEUROLOGI RSUP PROF. Dr. R. D. KANDOU MANADO PERIODE JANUARI – OKTOBER 2012

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Rio Christanto ◽  
Corry N. Mahama ◽  
Melke J. Tumboimbela
Keyword(s):  
Risk Factors ◽  
Stroke Risk ◽  
Risk Category ◽  
Stroke Patients ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
History Of ◽  
Male Sex ◽  
Acute Attacks ◽  
Diabetes Melitus

Abstract: Stroke is a serious neurological disease, with acute attacks that can lead to death. Closely related to the occurrence of stroke risk factors possessed by the patient, especially if there are risk factors that are not addressed properly. Aim: To know the profile of risk factors in stroke patients hospitalized in neurology. irina F  of  RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Methods: The study descriptive with retrospective method is to collect all the data of patients who had been diagnosed with stroke in inpatient neurology irina F RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Results: The results showed that the highest percentage of stroke patients are in the age group 51-65 years (45.2%), male sex (51.2%), high risk category of hypertension (92.2%), risk category Low dyslipidemia ((73.1%), low risk of diabetes mellitus (83.8%), history of heart problems (40.2%), had a history of smoking (8.2%). Conclusion: There are three factors that influence the risk of stroke incidence is age, gender and hypertension Keywords: stroke, risk factors Abstrak: Stroke merupakan penyakit neurologi yang serius, dengan serangan akut yang dapat menyebabkan kematian. Terjadinya stroke berkaitan erat dengan faktor risiko yang dipunyai oleh penderita, terutama bila faktor risiko yang ada tidak ditanggulangi dengan baik. Tujuan: Mengetahui profil faktor-faktor risiko pada pasien stroke yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai oktober 2012. Metode: Penelitian deskriktif  dengan metode retrospektif yaitu mengumpulkan semua data penderita yang telah didiagnosa dengan stroke  yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai Oktober 2012.  Hasil: Hasil penelitian menunjukan bahwa persentase terbanyak pasien stroke berada pada golongan umur 51-65 tahun (45,2%), berjenis kelamin laki-laki (51,2%), kategori risiko tinggi hipertensi (92,2%), kategori risiko rendah dislipidemia ((73,1%), risiko rendah diabetes melitus (83,8%), riwayat atau kelainan jantung (40,2%), memiliki riwayat merokok (8,2%). Simpulan: Terdapat 3 faktor risiko yang berpengaruh terhadap kejadian stroke yaitu umur, jenis kelamin dan hipertensi Kata kunci: Stroke, faktor risiko

scholarly journals Inflammatory cytokines and ischemic stroke risk

Neurology ◽  
2019 ◽  
Vol 92 (20) ◽  
pp. e2375-e2384 ◽  
Author(s):  
Nancy Swords Jenny ◽  
Peter W. Callas ◽  
Suzanne E. Judd ◽  
Leslie A. McClure ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Racial Disparity ◽  
Stroke Risk ◽  
Black Population ◽  
Sample Mean ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
Ischemic Stroke Risk

ObjectiveWe studied circulating interleukin (IL)–6, IL-8, and IL-10 concentrations and incident ischemic stroke risk in a biracial cohort, and determined if these cytokines mediated the racial disparity in stroke incidence affecting the black population.MethodsThe Reasons for Geographic and Racial Differences in Stroke study enrolled 30,237 black and white men and women age ≥45 in 2003-2007. We measured baseline IL-6, IL-8, and IL-10 in a case–cohort study of 557 participants with incident stroke over 5.4 years and 951 participants in a cohort sample.ResultsIL-6, but not IL-8 or IL-10, was higher in cases compared to the cohort sample (mean 4.5 vs 3.7 ng/mL; p < 0.001). Only IL-6 was associated with stroke risk factors. Adjusting for age, sex, and race, the hazard ratio (HR; 95% confidence interval) for incident stroke for the highest vs lowest quartile of IL-6 was 2.4 (1.6–3.4). HRs for the highest vs lowest quartiles of IL-8 and IL-10 were 1.5 (1.0–2.1) and 1.4 (1.0–1.9), respectively. After additional adjustment for stroke risk factors, only higher IL-6 remained associated with stroke risk (HR 2.0; 1.2–3.1). Associations did not differ by race. Mediation analyses showed that IL-6 mediated the black–white disparity in stroke risk, but mediation was via IL-6 associations with stroke risk factors.ConclusionsIn this biracial population-based sample, IL-6 was strongly associated with risk of incident stroke and mediated the racial disparity in stroke via inflammatory effects of risk factors. Further study on the clinical utility of IL-6 measurement in stroke risk assessment would be helpful.

scholarly journals Implications of Female Sex on Stroke Risk Factors, Care, Outcome and Rehabilitation: An Asian Perspective

2015 ◽  
Vol 39 (5-6) ◽  
pp. 302-308 ◽  
Author(s):  
Prachi Mehndiratta ◽  
Mohammad Wasay ◽  
Man Mohan Mehndiratta
Keyword(s):  
Risk Factors ◽  
Access To Health Care ◽  
Stroke Risk ◽  
Contraceptive Use ◽  
Social Issues ◽  
Recurrent Stroke ◽  
Stroke Care ◽  
Asian Women ◽  
Chewing Tobacco ◽  
Stroke Risk Factors

Background: Stroke affects 16.9 million people annually and the greatest burden of stroke is in low- and middle-income countries, where 69% of all strokes occur. Stroke risk factors, mortality and outcomes differ in developing countries as compared to the developed world. We performed a literature review of 28 articles pertaining to epidemiology of stroke in Asian women, stroke risk factors, gender-related differences, and stroke outcomes. Summary: Asian women differ from women worldwide due to differences in stroke awareness, risk factor profile, stroke subtypes, and social issues that impact stroke care. While Asian men have a higher incidence of stroke as compared to women overall, the long- and short-term outcomes in Asian women tend to be poorer. Both conventional and gender-specific risk factors contribute to stroke risk. Oral contraceptive use and addictions such as tobacco and alcohol are less prevalent among Asian women due to socio cultural differences. There is however, a much higher preponderance of pregnancy-related stroke and cardio-embolic stroke secondary to rheumatic heart disease and heavy use of chewing tobacco. The overall outcome is poor due to poor access to health care and lack of resources. Key Messages: Our review exposed the gaps in our knowledge about stroke risk factors and differences in stroke care provided to Asian women. While there are sociocultural barriers that impede the provision of immediate care to these stroke patients, much needs to be done by way of prevention of recurrent stroke and treatment of risk factors.

scholarly journals Trends in stroke incidence rates and stroke risk factors in Rotterdam, the Netherlands from 1990 to 2008

2012 ◽  
Vol 27 (4) ◽  
pp. 287-295 ◽  
Author(s):  
Renske G. Wieberdink ◽  
M. Arfan Ikram ◽  
Albert Hofman ◽  
Peter J. Koudstaal ◽  
Monique M. B. Breteler
Keyword(s):  
Risk Factors ◽  
The Netherlands ◽  
Stroke Risk ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Stroke Risk Factors

scholarly journals Quality of care for ischemic stroke in China vs India

Neurology ◽  
2018 ◽  
Vol 91 (14) ◽  
pp. e1348-e1354 ◽  
Author(s):  
Zixiao Li ◽  
Jeyaraj Pandian ◽  
P.N. Sylaja ◽  
Yilong Wang ◽  
Xingquan Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Scale Score ◽  
Stroke Risk ◽  
Stroke Care ◽  
Chinese Patients ◽  
Stroke Severity ◽  
Stroke Risk Factors ◽  
Indian Patients

ObjectiveTo understand stroke risk factors, status of stroke care, and opportunities for improvement as China and India develop national strategies to address their disproportionate and growing burden of stroke.MethodsWe compared stroke risk factors, acute management, adherence to quality performance measures, and clinical outcomes among hospitalized ischemic stroke patients using data from the Indo-US Collaborative Stroke Project (IUCSP) and China National Stroke Registry-II (CNSR-II). The IUCSP included 5 academic stroke centers from different geographic regions (n = 2,066). For comparison, the CNSR-II dataset was restricted to 31 academic hospitals among 219 participating sites from 31 provinces (n = 1,973).ResultsIndian patients were significantly younger, had health insurance less often, and had significantly different risk factors (more often diabetes mellitus, dyslipidemia, and coronary heart disease; less often prior stroke, hypertension, atrial fibrillation, and smoking). Hospitalized Indian patients had greater stroke severity (median NIH Stroke Scale score 10 vs 4), higher rates of IV thrombolysis within 3 hours (7.5% vs 2.4%), greater in-hospital mortality (7.9% vs 1.2%), and worse outcome (3-month modified Rankin Scale score 0–2, 49.3% vs 78.1%) (all p < 0.001). The poorer clinical outcomes were attributable mainly to greater stroke severity in IUCSP patients. Chinese patients more often received antithrombotics, stroke education, and dysphagia screening during hospitalization.ConclusionThese data provide insights into the status of ischemic stroke care in academic urban centers within 2 large Asian countries. Further research is needed to determine whether these patterns are representative of care across the countries, to explain differences in observed severity, and to drive improvements.

scholarly journals REGARDS: A Case Study in Aging and Disparities Research, Mentoring, and Data Sharing

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 855-856
Author(s):  
Virginia Howard ◽  
Jennifer Manly ◽  
Maria Glymour
Keyword(s):  
Risk Factors ◽  
Data Sharing ◽  
Racial Differences ◽  
Stroke Risk ◽  
Epidemiologic Studies ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
Incidence And Mortality ◽  
National Cohort ◽  
Ancillary Studies

Abstract Investigators in the NIH-funded REGARDS (REasons for Geographic and Racial Differences in Stroke) project have taken a novel approach to break the paradigm of epidemiologic studies limited to clinic-based convenience samples, by developing a national cohort of 30,239 black and white participants recruited from communities across all lower 48 US states, including 1,855 of the 3,033 counties. Mean age at enrollment (Jan 2003-Oct 2007) was 65.3 years. The four initial aims were to further understanding of: 1) geographic and racial differences in stroke risk factors; 2) geographic and racial differences in stroke incidence and mortality; 3) association of stroke risk factors and stroke risk (incidence and mortality) focusing on effect modification by race or region; and 4) establishment of a repository of serum, plasma, urine and DNA for use in future studies. When the grant was awarded, the study goals were broadened to include longitudinal remote assessment of cognitive function. A second in-home visit was completed May 2013-Dec 2016 including measures of functional status. The cohort is in its 17th year of follow-up. We will detail recruitment and enrollment methods, characteristics of the cohort and status, with brief overview of the biological, medical, psychosocial, environmental, and contextual data collected in the parent study. Speakers will discuss in more detail the stroke and cognitive data, ancillary studies focused on caregiver and heart disease outcomes, and provide examples of national and international mentoring that has leveraged REGARDS data. Finally, we will describe opportunities for additional data sharing and new ancillary studies.

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