scholarly journals Stroke and stroke risk factors as disease burden

2021 ◽  
pp. 146-151
Author(s):  
S. Ozturk ◽  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Cardiovascular Health ◽  
Stroke Risk ◽  
Heart Diseases ◽  
Health Indicators ◽  
The United States ◽  
Blood Cholesterol ◽  
Stroke Risk Factor

Stroke is the most common cause of disability and death in the world. Cardiovascular disease rates increase with age (10.9 % for people aged 20–30 years and 85.3 % for people older than 80 years). Coronary heart diseases is the leading cause of deaths attributable to cardiovascular diseases in the United States, followed by stroke, high BP, HF, diseases of the arteries, and other cardiovascular diseases. The report on the global burden of neurological disorders has shown that hemorrhagic stroke accounted for 35.7 % in it, and ischemic stroke, 22.4 %. Seven indicators are important and strategic to prevent cardiovascular disorders; they include healthy diet, sufficient physical activity, smokingstatius, BMI, cholesterol level, blood pressure, and glucose in blood on a fasting stomach. These indicators are associated with healthy behavior (diet quality, PA, smoking, BMI) which are as important as health factors (blood cholesterol, BP, blood glucose). There is a strong protective association between ideal cardiovascular health indicators and many clinical and preclinical conditions including premature all-cause mortality, stroke, CVD mortality, ischemic heart disease mortality, HF, deep venous thromboembolism, and pulmonary embolism. Atrial fibrillation, metabolic syndrome, renal failure, and sleep apnea are important risk factors which are modifiable and treatable. Air pollution has been reported as an increasing and very important risk factor for stroke. COVID-19 has been reported as another new stroke risk factor during the pandemic. Future targets must include each cardiovascular health indicator to decrease stroke risk burden and stroke risk.

Abstract WP236: The Urban-Rural Divide: Risk Factor Prevalence in Ischemic Stroke Patients Across Two Decades

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dinesh V Jillella ◽  
Sara Crawford ◽  
Anne S Tang ◽  
Rocio Lopez ◽  
Ken Uchino
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Regression Models ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Risk Factor Prevalence ◽  
Urban Rural ◽  
Artery Disease

Introduction: Regional disparities exist in stroke incidence and stroke related mortality in the United States. We aimed to elucidate the stroke risk factor prevalence trends based on urban versus rural location. Methods: From the National Inpatient Sample database the comorbid stroke risk factors were collected among hospitalized ischemic stroke patients during 2000-2016. Crude and age-and sex-standardized prevalence estimates were calculated for each risk factor during the time periods 2000-2008 and 2009-2016. We compared risk factor prevalence over the defined time periods using regression models, and differences in risk factor trends based on patient location categorized as urban (metropolitan with population of ≥ 1 million) and rural (neither micropolitan or metropolitan) using interaction terms in the regression models. Results: Stroke risk factor prevalence significantly increased from 2000-2008 to 2009-2016. When stratified based on patient location, most risk factors increased in both urban and rural groups. In the crude model, the urban to rural trend difference across 2000-08 and 2009-16 was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0008), diabetes mellitus (p<0.0001), coronary artery disease (p<0.0001), smoking (p<0.0001) and alcohol (p=0.02). With age and sex standardization, the urban to rural trend difference was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0007), coronary artery disease (p=0.01) and smoking (p<0.0001). Conclusion: The prevalence of vascular risk factors among ischemic stroke patients has increased over the last two decades. There exists an urban-rural divide, with rural patients showing larger increases in prevalence of several risk factors compared to urban patients.

Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Dawn M Aycock ◽  
Kenya D Kirkendoll ◽  
Kisha C Coleman ◽  
Karen C Albright ◽  
Anne W Alexandrov
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Perceived Control ◽  
Stroke Risk ◽  
Perceived Threat ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
History Of ◽  
Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

scholarly journals Using Cluster Analysis to Explore Associations between Cardiovascular Risk and Lifestyle Factors in a Workplace Wellness Program

2021 ◽  
Vol 5 (1) ◽  
pp. 30-41
Author(s):  
Heather Carter-Templeton ◽  
Gary Templeton ◽  
Barbara Ann Graves ◽  
Leslie G. Cole
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Risk Factor ◽  
Cardiovascular Health ◽  
The United States ◽  
Workplace Wellness ◽  
Wellness Program ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Ideal Cardiovascular Health

Background: Cardiovascular disease (CVD) is the number one cause of death in the United States with risk factors including hypertension, hyperlipidemia, diabetes, obesity, smoking, physical inactivity, age, genetics, and unhealthy diets. A university-based workplace wellness program (WWP) consisting of an annual biometric screening assessment with targeted, individualized health coaching was implemented in an effort to reduce these risk factors while encouraging and nurturing ideal cardiovascular health.Objective: The purpose of this study was to examine and describe the prevalence of single and combined, or multiple, CVD risk factors within a workplace wellness dataset.Methods: Cluster analysis was used to determine CVD risk factors within biometric screening data (BMI, waist circumference, LDL, total cholesterol, HDL, triglycerides, blood glucose age, ethnicity, and gender) collected during WWP interventions.Results: The cluster analysis provided visualizations of the distributions of participants having specific CVD risk factors. Of the 8,802 participants, 1,967 (22.4%) had no CVD risk factor, 1,497 (17%) had a single risk factor, and 5,529 (60.5%) had two or more risk factors. The majority of sample members are described as having more than one CVD risk factor with 78% having multiple.Conclusion: Cluster analysis demonstrated utility and efficacy in categorizing participant data based on their CVD risk factors. A baseline analysis of data was captured and provided understanding and awareness into employee health and CVD risk. This process and analysis facilitated WWP planning to target and focus on education to promote ideal cardiovascular health.

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 P313: Poor Cardiovascular Health Knowledge despite the Rising Epidemic of Cardiovascular Diseases: findings from a peri-urban Nepalese community

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Abhinav Vaidya ◽  
Umesh R Aryal ◽  
Alexandra Krettek
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Health Behaviour ◽  
Low Income ◽  
Heart Attack ◽  
Cardiovascular Health ◽  
Health Knowledge ◽  
Heart Diseases ◽  
Community Based Interventions ◽  
Cross Sectional

Nepal, a low-income South Asian country, is facing a growing epidemic of atherosclerotic cardiovascular diseases. Information on how well its population knows about the underlying risk factors and possible prevention and control strategies is an important determinant in tackling the epidemic. Studies indicate Nepalese people have poor knowledge regarding cardiovascular health, for example, about symptoms of heart attack or diabetes. We conducted a study on cardiovascular health literacy in a peri-urban area near Kathmandu and tested the hypothesis that better cardiovascular health knowledge is associated with superior cardiovascular health behaviour. For this cross-sectional study, we conducted face-to-face interviews with 777 consenting adults aged 25-59 years from six randomly sampled clusters of Duwakot and Jhaukhel communities between September and November 2011. We used WHO-STEPs questionnaire to gather information on demographic, behavioural and anthropometric variables. Additionally, we did a thorough literature search to construct questions on cardiovascular health knowledge and attitude. Scores were given to knowledge, attitude and behaviour/practice components which were then aggregated to calculate composite median percent scores. Five categories from highest to lowest quintiles of median percent scores were then generated. Seventy percent of the respondents were females- out of which two-thirds were housewives, and a third was without formal education. A fifth of the 229 male respondents were doing agriculture-based work. When asked to spontaneously name the risk factors, respondents showed low overall knowledge- ranging from 1% for diabetes and 29% for smoking. Sixty percent of them did not know any heart attack symptom. Chest pain as a heart attack sign was known only to 14% of the respondents. Nonetheless, 86% of them thought heart diseases could be prevented by improving lifestyles. However, 65% of men and 54% of women did not want to change their lifestyle as they did not consider themselves to be at risk. Further, among those with highest knowledge quintile score, only 14.7% had highest attitude quintile score, and only 13.4% had highest behaviour quintile score. Likewise, among those with lowest knowledge quintile score, 26% had lowest attitude quintile score, and 16.4% had lowest behaviour quintile score. In conclusion, despite the rising burden of cardiovascular epidemic in Nepal, population-level knowledge on cardiovascular health is still poor. Further, better knowledge did not necessarily translate into superior cardiovascular health behaviour. Therefore, community-based interventions that improve all the three components should be promoted rather than those which influence only the knowledge aspect.

Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score

2015 ◽  
Vol 114 (10) ◽  
pp. 826-834 ◽  
Author(s):  
Flemming Skjøth ◽  
Peter Nielsen ◽  
Torben Bjerregaard Larsen ◽  
Gregory Lip
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Additional Risk Factor ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Long Run ◽  
One Year ◽  
Net Clinical Benefit

SummaryOral anticoagulation (OAC) to prevent stroke has to be balanced against the potential harm of serious bleeding, especially intracranial haemorrhage (ICH). We determined the net clinical benefit (NCB) balancing effectiveness and safety of no antithrombotic therapy, aspirin and warfarin in AF patients with none or one stroke risk factor. Using Danish registries, we determined NCB using various definitions intrinsic to our cohort (Danish weights at 1 and 5 year follow-up), with risk weights which were derived from the hazard ratio (HR) of death following an event, relative to HR of death after ischaemic stroke. When aspirin was compared to no treatment, NCB was neutral or negative for both risk strata. For warfarin vs no treatment, NCB using Danish weights was neutral where no risk factors were present and using five years follow-up. For one stroke risk factor, NCB was positive for warfarin vs no treatment, for one year and five year follow-up. For warfarin vs aspirin use in patients with no risk factors, NCB was positive with one year follow-up, but neutral with five year follow-up. With one risk factor, NCB was generally positive for warfarin vs aspirin. In conclusion, we show a positive overall advantage (i.e. positive NCB) of effective stroke prevention with OAC, compared to no therapy or aspirin with one additional stroke risk factor, using Danish weights. ‘Low risk’ AF patients with no additional stroke risk factors (i.e. CHA2DS2-VASc 0 in males, 1 in females) do not derive any advantage (neutral or negative NCB) with aspirin, nor with warfarin therapy in the long run.Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief.

scholarly journals An Examination of Stroke-Related Knowledge in Male Stroke Survivors Living in the South Carolina Stroke Belt

2014 ◽  
Vol 8 (6) ◽  
pp. 532-537 ◽  
Author(s):  
Charles Ellis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Racial Differences ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Stroke Survivors ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
Stroke Knowledge

Racial differences have been observed in stroke-related knowledge and knowledge of specific stroke risk factors and stroke prevention practices. Using data from 134 male stroke survivors, racial differences in overall knowledge, risk factor knowledge, and stroke prevention practices were examined using the Stroke Knowledge Test. Knowledge that diabetes doubles ones risk of stroke was present in 48% of the participants, while knowledge of aspirin in the prevention of stroke by stopping blood clot formation was reported in 83% of the participants. Findings indicate participants were knowledgeable that obesity increased risk of stroke (71%) and high blood pressure was the most important stroke risk factor (70%). Participants indicated knowledge that diet, exercise, and controlling blood pressure and cholesterol reduces risk of stroke (86%). In regression models, there were no significant race differences in overall stroke knowledge or the odds of knowledge of information related to stroke risk factors and stroke prevention practices after adjusting for age, education, and marital status. Although stroke-related knowledge did not differ by race, stroke survivors exhibited gaps in stroke knowledge particularly of knowledge of common risk factors. These factors should be considered in approaches to improve stroke-related knowledge in all stroke survivors.

Chronic Diseases and Risk Factor Trends in Japan

2020 ◽  
pp. 163-178
Author(s):  
Hiroyasu Iso ◽  
Kotatsu Maruyama ◽  
Kazumasa Yamagishi
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischaemic Heart Disease ◽  
Cardiovascular Health ◽  
Population Level ◽  
Blood Cholesterol ◽  
Ageing Population ◽  
Public Health Services ◽  
Urban Rural

Top longevity in Japan since the 1990s was primarily due to a large reduction in the incidence of stroke and a moderate reduction in ischaemic heart disease. Such trends in cardiovascular diseases in Japan are attributable to population-level health and changes in cardiovascular risk factors, especially (a) the high but largely reduced prevalence of hypertension and smoking (in men), and (b) the low but increased or stable prevalence of high blood cholesterol and the low prevalence of overweight and diabetes. Economic development, integrated activities in public health services, and improved medical care contributed to these favourable trends for stroke and ischaemic heart disease in Japan, reducing the urban-rural inequalities in cardiovascular diseases, risk factors and behaviours. An important aspect of cardiovascular health in Japan is national resistance to westernization of diet although meat and dairy consumption has tended to increase. Growing socioeconomic gradients among the ageing population however might worsen the health inequalities in cardiovascular health, requiring urgent measures for healthy ageing.

scholarly journals Clocks, Rhythms, Sex, and Hearts: How Disrupted Circadian Rhythms, Time-of-Day, and Sex Influence Cardiovascular Health

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 883
Author(s):  
O. Hecmarie Meléndez-Fernández ◽  
James C. Walton ◽  
A. Courtney DeVries ◽  
Randy J. Nelson
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Circadian Rhythms ◽  
Cardiovascular Health ◽  
Biological Rhythms ◽  
Cardiovascular Function ◽  
The United States ◽  
Time Of Day ◽  
And Behavior

Cardiovascular diseases are the top cause of mortality in the United States, and ischemic heart disease accounts for 16% of all deaths around the world. Modifiable risk factors such as diet and exercise have often been primary targets in addressing these conditions. However, mounting evidence suggests that environmental factors that disrupt physiological rhythms might contribute to the development of these diseases, as well as contribute to increasing other risk factors that are typically associated with cardiovascular disease. Exposure to light at night, transmeridian travel, and social jetlag disrupt endogenous circadian rhythms, which, in turn, alter carefully orchestrated bodily functioning, and elevate the risk of disease and injury. Research into how disrupted circadian rhythms affect physiology and behavior has begun to reveal the intricacies of how seemingly innocuous environmental and social factors have dramatic consequences on mammalian physiology and behavior. Despite the new focus on the importance of circadian rhythms, and how disrupted circadian rhythms contribute to cardiovascular diseases, many questions in this field remain unanswered. Further, neither time-of-day nor sex as a biological variable have been consistently and thoroughly taken into account in previous studies of circadian rhythm disruption and cardiovascular disease. In this review, we will first discuss biological rhythms and the master temporal regulator that controls these rhythms, focusing on the cardiovascular system, its rhythms, and the pathology associated with its disruption, while emphasizing the importance of the time-of-day as a variable that directly affects outcomes in controlled studies, and how temporal data will inform clinical practice and influence personalized medicine. Finally, we will discuss evidence supporting the existence of sex differences in cardiovascular function and outcomes following an injury, and highlight the need for consistent inclusion of both sexes in studies that aim to understand cardiovascular function and improve cardiovascular health.

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