Abstract TP172: Analysis of Stroke Risk and Risk Factor Awareness in Samoa

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Lydia A Trupe ◽  
Viali Lameko
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Risk Factor ◽  
High Risk ◽  
Stroke Risk ◽  
Warning Signs ◽  
Low Risk ◽  
Hospital Inpatient ◽  
Stroke Risk Factors ◽  
The Impact

Background: The prevalence of stroke in Samoa is extremely high due to high rates of risk factors such as obesity, hypertension, and diabetes. Stroke remains the leading cause of death in Samoa. We hypothesized that poor knowledge of stroke risk factors and warning signs contributes to high stroke prevalence in Samoa, such that widespread dissemination of information might induce lifestyle changes (e.g. diet and exercise) and cause more people to seek treatment for stroke. Methods: We enrolled a series of English-speaking Samoan adults age 25- 65 (mean=45) on the Tupua Tamasese Meaole Hospital inpatient service from January to April, 2012. Because they were inpatients, they tended to be at a higher stroke risk than the general population. Detailed interviews were conducted regarding knowledge of stroke risk factors and warning signs and assessment of personal stroke risk. Participants’ cerebrovascular risk was categorized as high, moderate or low based on their risk factors. Participants were informed of their stroke risk, ways to reduce stroke risk, warning signs and what to do in the event of stroke. Results: Of 19 adults interviewed, 8 were categorized as “high risk”, 3 as “moderate risk” and 8 as “low risk.” Participants were able to name a mean of 0.74 risk factors for stroke and mean of 1.2 warning signs. 21% incorrectly named stress as a common risk factor. The most common risk factors correctly named were obesity/unhealthy diet (23.8%) and diabetes (15.8%). There was no association between stroke risk classification and participant’s belief that they were at risk of stroke (chi square=1.6; ns); 50% of high-risk participants and 25% of low risk patients believed they were at risk of having a stroke. High-risk participants, compared to low-risk participants, had a slightly higher knowledge of both stroke risk factors (mean=1 vs. 0.25) and warning signs (2 vs. 0.63). Conclusion: In Samoa, knowledge of stroke risk factors and warning signs is very low. It is likely that many Samoans receive health information after developing medical conditions; thus, high-risk individuals tend to have slightly higher knowledge. We aim to conduct a larger study with follow-up interviews to determine the impact of education.

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

scholarly journals The Risk of Stroke Using CHA2 DS2 -VASc Score in Hemodialysis Patients at a Tertiary Hospital in Riyadh, Saudi Arabia

2019 ◽  
Vol 4 (7) ◽  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Stroke Risk ◽  
Hemodialysis Patients ◽  
Low Risk ◽  
High Risk Patients ◽  
Stroke Risk Factors ◽  
Increased Risk ◽  
Risk Patients ◽  
History Of

Introduction: Patients undergoing hemodialysis are at increased risk of stroke. However, less known about the impact of some of the stroke risk factors, and the value of stroke risk scores in determining the risk in those patients. Our main goal. To assess the risk factors for stroke in hemodialysis patients and the use of the new CHA2DS2-VASc score for stroke assessment. Methods: Single center, retrospective cohort study of 336 patients undergoing hemodialysis from June 24, 2018, to September 6, 2018, was recruited. Baseline demographics, clinical, and laboratory data were collected. We calculated the CHA2 DS2 -VASc score for stroke assessment in all patients and categorized them into high, moderate and low risk patients according to CHA2 DS2 - VASc score and subcategorized them to two groups atrial fibrillation (AFib) and Non- Atrial fibrillation (Non AFib) patients. Results: 336 patients were included in our study; the majority of patients were at high risk with a CHA2 DS2 -VASc Score mean of 2.9± 1.5, although history of stroke was observed only in 15 patients (4.46%). According to CHA2 DS2 - VASc score, 280 patients were at high risk, 172 (51.19%) were high-risk patients on treatment (anticoagulant or antiplatelet) and 108(32.14%) patients were high risk patients not on treatment 48 were at moderate risk (14.28%) and 8 were at low risk (2.38 %). Patients were divided into subgroups as non-AFib and AFib. In non-AFib patients 320 (95.23%), high-risk patients 103 (32.18%) were not treated; high-risk patients with treatment are 162 (50.62%), moderate patients were 47 (14.68%), 8(2.5%) was in low risk. AFib patients were 16 with a mean CHA2 DS2 -VASc score of 4.4±1.1. Patients with AFib were all at high risk except 1 was at moderate risk (6.25%). There were 11 (68.75%) patients on treatment and 5 (31.25%) patients not on treatment. The risk factors for stroke that were statistically significant in increasing score risk for all patients were: age > 65 (95% CI, -2.04– -1.29; p = 0.000), being female (95% CI, -1.36– -0.68; p = 0.000) hypertension (95% CI, -2.59– -1.37; p = 0.000), diabetes (95% CI, -2.10– -1.50; p = 0.000), CVD (95% CI, -2.07– -1.24; p=0.000), history of stroke or TIA (95% CI, -3.70– -2.03; p = 0.000), CHF or LVEF (95% CI, -2.28– - 0.91; p = 0.000). Conclusions: The risk of stroke in hemodialysis patients is significant according to the use of CHA2 DS2 -VASc score in Non-AFib hemodialysis patients shows supportive evidence of increased risk of stroke in those patients, which suggest the importance of close monitoring of patients with stroke risk factors by the nephrologist and the stroke team which will lead to the initiation of early prophylaxis in those patients.

Abstract TP203: Reducing Stroke Burden in Uganda

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mark Kaddumukasa ◽  
Jane Nakibuuka ◽  
James Kayima ◽  
Elly Katabira ◽  
Carol Blixen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Growth Patterns ◽  
Warning Signs ◽  
Clear Understanding ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Study Participants ◽  
Stroke Knowledge

Background: Stroke is a neurological condition with rapidly increasing burden in many low- and middle-income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. Methods: A cross sectional survey was conducted in urban Mukono district in central Uganda. Through a systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception, using a pretested structured questionnaire. Results: Of the 440 study participants enrolled for this study nearly 52% correctly reported that stroke involves the brain, while 57% reported that stroke is preventable. Majority of the participants 75.7% reported stress as a contributing factor. Only 45.7% of the study participants reported hypertension as a risk factor. Only two (0.5%) study participants identified cigarette smoking as a stroke risk factor. Of the eighty six study participants with hypertension only 39.5% knew hypertension as a risk factor and only 10.7% knew three or more stroke risk factors. Conclusion: Stroke knowledge is poor in urban Uganda. Individuals with hypertension had poor knowledge regarding stroke in spite their high risk for stroke. Stress and hypertension are the leading perceived risk factors in our settings. While stress is highly reported as a stroke risk factor in this study hypertension is likely a more amenable and practical intervention target.

Abstract WP224: Impact of Stroke Risk Factors on Ethnic Stroke Disparities Among Midlife Mexican Americans and Non-hispanic Whites

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Rajiv C Patel ◽  
Brisa Sanchez ◽  
Lewis Morgenstern ◽  
Chengwei Li ◽  
Lynda Lisabeth
Keyword(s):  
Risk Factors ◽  
High School ◽  
At Risk ◽  
Risk Factor ◽  
Health Insurance ◽  
Mexican Americans ◽  
Stroke Risk ◽  
Census Data ◽  
Population At Risk ◽  
Stroke Risk Factors

Introduction: Overall ischemic stroke (IS) incidence has declined in the US, but has remained stable among midlife (age 45-59) adults and is higher in midlife Mexican Americans (MAs). We examined the contribution of stroke risk factors to ethnic differences in IS rates among midlife MAs and non-Hispanic Whites (NHWs) in a population-based study. Methods: Incident IS (N=823) counts and corresponding risk factors were identified from the BASIC Project, Nueces County, Texas (2000-2010). US Census data (2000) for Nueces County was used to estimate the population at-risk for stroke, and the Texas Behavioral Risk Factor Surveillance System for Public Health Region 11(2000-2010) was used to estimate prevalence of risk factors in the stroke free population. Poisson regressions were run combining stroke counts (numerator) and population at-risk counts (denominator) classified by ethnicity and risk factor status to estimate unadjusted and risk factor adjusted associations between ethnicity and IS rates. Separate models were run for each risk factor (diabetes, hypertension, coronary heart disease, high cholesterol, education < high school, no health insurance, current smoking, BMI>30), and extended to include an interaction term between ethnicity and risk factor. Results: The crude ethnic IS rate ratio (RR) comparing MAs with NHWs was 2.13 (95% CI: 1.84-2.47). The ethnic RR was lower in models that adjusted for diabetes (RR:1.54; 95% CI: 1.31-1.78), hypertension (RR: 1.92; 95% CI: 1.65-2.22), and education < high school (RR: 2.02; 95% CI: 1.72-2.38) compared to the crude association. Ethnicity significantly modified associations between diabetes, smoking, health insurance, education and IS rates. Associations between diabetes and IS rates was greater among MAs (RR: 6.82, 95% CI: 5.76-8.07) compared with NHWs (RR: 4.40, 95% CI: 3.33-5.81), while smoking associations were greater in NHWs (MA RR: 2.61, 95% CI: 2.20-3.10; NHW RR: 3.49, 95% CI: 2.73-4.46). Socioeconomic variables increased IS risk in NHWs but were insignificant or protective in MAs. Conclusion: Traditional stroke risk factors may contribute to midlife ethnic stroke disparities; particularly diabetes, given its high prevalence and stronger association with IS among midlife MAs as compared with NHWs.

Abstract P342: Disparities in Awareness of Stroke Symptoms Among Different Socioeconomic, Ethnic/Race, and At-risk-of-stroke Groups

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Phoebe Tran
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Risk Factor ◽  
Chest Pain ◽  
Sample Size ◽  
Stroke Risk ◽  
The Body ◽  
Stroke Risk Factors ◽  
Stroke Symptom ◽  
Race Ethnicity

Findings from a few small studies suggested that disparities in awareness of stroke symptoms lead to disparities in delays of receiving treatment and outcomes of patients with stroke. Hence it is important to conduct a study with a large sample size to understand the associations between awareness of symptoms of stroke with various socioeconomic factors as well as with modifiable stroke risk factors. We assessed the hypotheses that there are disparities in awareness of different stroke symptoms among different groups with respect to various SES factors (e.g., self-reported race, ethnicity, education, age, and income) in the presence/absence of modifiable stroke risk factors (e.g., smoking status, exercise, body mass index, and blood pressure). We combined four Behavioral Risk Factor Surveillance Surveys (BRFSS) from 2003, 2005, 2007, and 2009 to create a sample of 1,051,834 participants. We ran six logistic regression models, one for each of the measures of awareness of six common stroke symptoms (e.g., sudden confusion, numbness on one side of the body, sudden vision loss, sudden chest pain, sudden dizziness, and severe unexplained headache). The unweighted sample size in each of the six models was greater than 120,000. In addition, we calculated marginal probabilities which give the probability of an outcome (e.g., being aware of a specific stroke symptom) with respect to a specific factor (e.g., in the presence/absence of a stroke risk factor) in the context of averaging over all other factors/covariates. While there was low awareness of stroke symptoms among the US population except for recognition of chest pain or discomfort, we did find an association between the awareness of stroke symptoms with gender, educational levels, and income levels. Additionally, among all the ethnic groups, Native Americans had the lowest awareness of five out of six stroke symptoms. On the other hand, White only-non Hispanic, while being relatively better aware of several stroke symptoms, had the lowest awareness of the most common stroke symptom of sudden chest pain compared with other race/ethnicity groups. In conclusion, the findings from this study can serve as a useful guide to facilitating targeted educational efforts aimed at improving awareness of stroke symptoms that may ultimately reduce disparities in the outcomes of patients at risk for stroke.

scholarly journals Do Multiple Stroke-Related Educational Opportunities Enhance Stroke Knowledge among Students Enrolled in Communication Sciences and Disorders Programs?

2008 ◽  
Author(s):  
Kristen Lankford ◽  
E. Marshall ◽  
Amanda Pittman ◽  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Early Warning ◽  
Stroke Risk ◽  
Warning Signs ◽  
Stroke Risk Factors ◽  
Early Warning Signs ◽  
Multiple Stroke ◽  
Level Of Instruction ◽  
Stroke Knowledge

Purpose: Stroke education modules have been added to medical school curriculums to improve stroke knowledge in graduate physicians, and this has resulted in positive outcomes. These findings suggest that similar strategies may be successful in graduate programs such as Communication Sciences and Disorders (CSD). The purpose of this study was to examine the impact of multiple stroke-related education opportunities on students enrolled in CSD programs. Methods: Seventy-six first and second year students enrolled in a Communication Sciences and Disorders program completed a survey of stroke risk factors and early warning signs of stroke. Results: Risk factor knowledge - 97% identified smoking as a risk factor; 61% identified diabetes; 90% identified high cholesterol; 84% identified age, and 90% identified physical inactivity. Students varied in their recognition of diabetes as a stroke risk factor based on their level of instruction. Early warning signs and first response knowledge - 83% recognized sudden confusion or trouble speaking; 100% recognized sudden facial, arm or leg weakness; 83% recognized sudden vision loss; 76% recognized sudden trouble walking; and 75% recognized sudden headache as early warning signs of stroke. Seventy-nine percent recognized calling 9-1-1 as the appropriate first action. Students varied in their recognition of sudden trouble walking and severe headache as an early warning sign of stroke based on their level of instruction. Conclusions: Most students recognized individual stroke risk factors and early warning signs, but few recognized multiple risk factors and warning signs. Multiple education opportunities appear to enhance student recognition of risk factors and warning signs.

scholarly journals Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors

2019 ◽  
Vol 27 (4) ◽  
pp. 394-406 ◽  
Author(s):  
Katharina Lechner ◽  
Clemens von Schacky ◽  
Amy L McKenzie ◽  
Nicolai Worm ◽  
Uwe Nixdorff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Ambient Air ◽  
Lifestyle Factors ◽  
Nutrient Sensing ◽  
Low Risk ◽  
Ambient Air Pollution ◽  
Cardiometabolic Health ◽  
The Impact

Despite major efforts to reduce atherosclerotic cardiovascular disease (ASCVD) burden with conventional risk factor control, significant residual risk remains. Recent evidence on non-traditional determinants of cardiometabolic health has advanced our understanding of lifestyle–disease interactions. Chronic exposure to environmental stressors like poor diet quality, sedentarism, ambient air pollution and noise, sleep deprivation and psychosocial stress affect numerous traditional and non-traditional intermediary pathways related to ASCVD. These include body composition, cardiorespiratory fitness, muscle strength and functionality and the intestinal microbiome, which are increasingly recognized as major determinants of cardiovascular health. Evidence points to partially overlapping mechanisms, including effects on inflammatory and nutrient sensing pathways, endocrine signalling, autonomic function and autophagy. Of particular relevance is the potential of low-risk lifestyle factors to impact on plaque vulnerability through altered adipose tissue and skeletal muscle phenotype and secretome. Collectively, low-risk lifestyle factors cause a set of phenotypic adaptations shifting tissue cross-talk from a proinflammatory milieu conducive for high-risk atherosclerosis to an anti-atherogenic milieu. The ketone body ß-hydroxybutyrate, through inhibition of the NLRP-3 inflammasome, is likely to be an intermediary for many of these observed benefits. Adhering to low-risk lifestyle factors adds to the prognostic value of optimal risk factor management, and benefit occurs even when the impact on conventional risk markers is discouragingly minimal or not present. The aims of this review are (a) to discuss novel lifestyle risk factors and their underlying biochemical principles and (b) to provide new perspectives on potentially more feasible recommendations to improve long-term adherence to low-risk lifestyle factors.

Public health campaigns and their effect on stroke knowledge in a high-risk urban population: A five-year study

Vascular ◽  
2017 ◽  
Vol 25 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Maged M Metias ◽  
Naomi Eisenberg ◽  
Michael D Clemente ◽  
Elizabeth M Wooster ◽  
Andrew D Dueck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Stroke Risk ◽  
High Risk Population ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Awareness Campaigns ◽  
Stroke Symptom ◽  
Stroke Knowledge

Background The level of knowledge of stroke risk factors and stroke symptoms within a population may determine their ability to recognize and ultimately react to a stroke. Independent agencies have addressed this through extensive awareness campaigns. The aim of this study was to determine the change in baseline knowledge of stroke risk factors, symptoms, and source of stroke knowledge in a high-risk Toronto population between 2010 and 2015. Methods Questionnaires were distributed to adults presenting to cardiovascular clinics at the University of Toronto in Toronto, Canada. In 2010 and 2015, a total of 207 and 818 individuals, respectively, participated in the study. Participants were identified as stroke literate if they identified (1) at least one stroke risk factor and (2) at least one stroke symptom. Results A total of 198 (95.6%) and 791 (96.7%) participants, respectively, completed the questionnaire in 2010 and 2015. The most frequently identified risk factors for stroke in 2010 and 2015 were, respectively, smoking (58.1%) and hypertension (49.0%). The most common stroke symptom identified was trouble speaking (56.6%) in 2010 and weakness, numbness or paralysis (67.1%) in 2015. Approximately equal percentages of respondents were able to identify ≥1 risk factor (80.3% vs. 83.1%, p = 0.34) and ≥1 symptom (90.9% vs. 88.7%, p = 0.38). Overall, the proportion of respondents who were able to correctly list ≥1 stroke risk factors and stroke symptoms was similar in both groups.(76.8% vs. 75.5%, p = 0.70). The most commonly reported stroke information resource was television (61.1% vs. 67.6%, p = 0.09). Conclusion Stroke literacy has remained stable in this selected high-risk population despite large investments in public campaigns over recent years. However, the baseline remains high over the study period. Evaluation of previous campaigns and development of targeted advertisements using more commonly used media sources offer opportunities to enhance education.

scholarly journals Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Bloodstream Infections ◽  
Low Risk ◽  
Moderate Risk ◽  
Streptococcal Species ◽  
Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

scholarly journals 947. Stroke demographics and risk factor profile in HIV infected individuals in Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Folusakin Ayoade ◽  
Dushyantha Jayaweera
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clinical Research ◽  
Stroke Risk ◽  
Research Network ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Risk Factor Profile ◽  
Stroke Risk Factors ◽  
Living With Hiv

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures

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