Prevalence of Stroke Risk Factors and Their Distribution Based on Stroke Subtypes in Gorgan: A Retrospective Hospital-Based Study-2015-2016

Mahdi Habibi-Koolaee, Leila Shahmoradi, Sharareh R Niakan Kalhori, Hossein Ghannadan, Erfan Younesi, Mahdi Habibi-Koolaee, Leila Shahmoradi, Sharareh R Niakan Kalhori, Hossein Ghannadan, Erfan Younesi

Abstract

Background: Stroke is a leading cause of death and disability worldwide. According to the Iranian Ministry of Medical Health and Education, out of 100,000 stroke incidents in the country, 25,000 lead to death. Thus, identifying risk factors of stroke can help healthcare providers to establish prevention strategies. This study was conducted to investigate the prevalence of stroke risk factors and their distribution based on stroke subtypes in Sayad Shirazi Hospital, Gorgan, Northeastern Iran.

Material and methods: A retrospective hospital-based study was conducted at Sayad Shirazi Hospital in Gorgan, the only referral university hospital for stroke patients in Gorgan city. All medical records with a diagnosis of stroke were identified based on the International Classification of Diseases, Revision 10, from August 23, 2015, to August 22, 2016. A valid and reliable data gathering form was used to capture data about demographics, diagnostics, lifestyle, risk factors, and medical history.

Results: Out of 375 cases, two-thirds were marked with ischemic stroke with mean ages (standard deviation) of 66.4 (14.2) for men and 64.6 (14.2) for women. The relationship between stroke subtypes and age groups (P=0.008) and hospital outcome (P=0.0001) was significant. Multiple regression analysis showed that hypertension (Exp. (B) =1.755, P=0.037), diabetes mellitus (Exp. (B) =0.532, P=0.021), and dyslipidemia (Exp. (B) =2.325, P=0.004) significantly increased the risk of ischemic stroke.

Conclusion: Overall, hypertension, diabetes mellitus, and dyslipidemia were the major risk factors of stroke in Gorgan. Establishment of stroke registry (population- or hospital-based) for the province is recommended.

References

    1. Mozaffarian D., Benjamin E. J., Go A. S., Arnett D. K., Blaha M. J., Cushman M., et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–e322.
    1. Bennett D. A., Krishnamurthi R. V., Barker-Collo S., et al. The global burden of ischemic stroke: Findings of the GBD 2010 study. Global Heart. 2014;9(1):107–112. doi: 10.1016/j.gheart.2014.01.001.
    1. Krishnamurthi R. V., Moran A. E., Forouzanfar M. H., et al. The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Global Heart. 2014;9(1):101–106. doi: 10.1016/j.gheart.2014.01.003.
    1. Hosseini A. A., Sobhani-Rad D., Ghandehari K., Benamer H. T. S. Frequency and clinical patterns of stroke in Iran - Systematic and critical review. BMC Neurology. 2010;10:p. 72. doi: 10.1186/1471-2377-10-72.
    1. Azarpazhooh M. R., Etemadi M. M., Donnan G. A., et al. Excessive incidence of stroke in iran: Evidence from the mashhad stroke incidence study (MSIS), a population-based study of stroke in the middle east. Stroke. 2010;41(1):e3–e10. doi: 10.1161/STROKEAHA.109.559708.
    1. Sarrafzadegan N., Gharipour M., Sadeghi M., et al. Metabolic Syndrome and the Risk of Ischemic Stroke. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2017;26(2):286–294. doi: 10.1016/j.jstrokecerebrovasdis.2016.09.019.
    1. Fahimfar N., Khalili D., Mohebi R., Azizi F., Hadaegh F. Risk factors for ischemic stroke; results from 9 years of follow-up in a population based cohort of Iran. BMC Neurology. 2012;12, article no. 117 doi: 10.1186/1471-2377-12-117.
    1. Ghayour-Mobarhan M., Moohebati M., Esmaily H., et al. Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation. International Journal of Public Health. 2015;60(5):561–572. doi: 10.1007/s00038-015-0679-6.
    1. Talaei M., Sarrafzadegan N., Sadeghi M., et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan cohort study. Archives of Iranian Medicine. 2013;16(3):138–144.
    1. Bang O. Y., Ovbiagele B., Kim J. S. Nontraditional risk factors for ischemic stroke: An update. Stroke. 2015;46(12):3571–3578. doi: 10.1161/STROKEAHA.115.010954.
    1. Hopewell J. C., Clarke R. Emerging Risk Factors for Stroke: What Have We Learned from Mendelian Randomization Studies? Stroke. 2016;47(6):1673–1678. doi: 10.1161/STROKEAHA.115.010646.
    1. von Sarnowski B., Putaala J., Grittner U., et al. Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the stroke in young fabry patients study. Stroke. 2013;44(1):119–125. doi: 10.1161/STROKEAHA.112.665190.
    1. Togha M., Bakhtavar K. Factors associated with in-hospital mortality following intracerebral hemorrhage: A three-year study in Tehran, Iran. BMC Neurology. 2004;4, article no. 9 doi: 10.1186/1471-2377-4-9.
    1. Hosaini S. A., Bazrafshan H. A statistical study on the role of high-risk factors in the incidence of CVA. Journal of Gorgan University of Medical Sciences. 2001;3(2):76–80.
    1. Kim A. S., Cahill E., Cheng N. T. Global stroke belt: geographic variation in stroke burden worldwide. Stroke. 2015;46(12):3564–3570. doi: 10.1161/strokeaha.115.008226.
    1. Delbari A., Salman Roghani R., Tabatabaei S. S., Rahgozar M., Lokk J. Stroke epidemiology and one-month fatality among an urban population in Iran. International journal of stroke : official journal of the International Stroke Society. 2011;6(3):195–200. doi: 10.1111/j.1747-4949.2010.00562.x.
    1. Ahangar A. A., Vaghefi S. B. A., Ramaezani M. Epidemiological evaluation of stroke in Babol, Northern Iran (2001-2003) European Neurology. 2005;54(2):93–97. doi: 10.1159/000088643.
    1. Williams L. N., Brown R. D. Management of unruptured intracranial aneurysms. Neurology: Clinical Practice. 2013;3(2):99–108. doi: 10.1212/cpj.0b013e31828d9f6b.
    1. Allen C. L., Bayraktutan U. Risk factors for ischaemic stroke. International journal of stroke : official journal of the International Stroke Society. 2008;3(2):105–116. doi: 10.1111/j.1747-4949.2008.00187.x.
    1. Teo K., Lear S., Islam S., et al. Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study. Journal of the American Medical Association. 2013;309(15):1613–1621. doi: 10.1001/jama.2013.3519.
    1. O'Donnell M. J., Denis X., Liu L., et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet. 2010;376(9735):112–123. doi: 10.1016/S0140-6736(10)60834-3.
    1. Aronow W. S. Hypertension-related stroke prevention in the elderly. Current Hypertension Reports. 2013;15(6):582–589. doi: 10.1007/s11906-013-0384-x.
    1. Malekzadeh M. M., Etemadi A., Kamangar F., et al. Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population. Journal of Hypertension. 2013;31(7):1364–1371. doi: 10.1097/HJH.0b013e3283613053.
    1. Sepanlou S. G., Sharafkhah M., Poustchi H., et al. Hypertension and mortality in the Golestan Cohort Study: A prospective study of 50 000 adults in Iran. Journal of Human Hypertension. 2016;30(4):260–267. doi: 10.1038/jhh.2015.57.
    1. Bilic I., Dzamonja G., Lusic I., Matijaca M., Caljkusic K. Risk factors and outcome differences between ischemic and hemorrhagic stroke. Acta Clinica Croatica. 2009;48(4):399–403.
    1. Zhang J., Wang Y., Wang G. N., Sun H., Sun T., Shi J. Q., et al. Clinical factors in patients with ischemic versus hemorrhagic stroke in East China. World journal of emergency medicine. 2011;2(1):18–23.
    1. Hisham N. F., Bayraktutan U. Epidemiology, pathophysiology, and treatment of hypertension in ischaemic stroke patients. Journal of Stroke and Cerebrovascular Diseases. 2013;22(7):e4–e14. doi: 10.1016/j.jstrokecerebrovasdis.2012.05.001.
    1. Law M. R., Morris J. K., Wald N. J. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. British Medical Journal. 2009;338 doi: 10.1136/bmj.b1665.b1665
    1. Pinto E. Blood pressure and ageing. Postgraduate Medical Journal. 2007;83(976):109–114. doi: 10.1136/pgmj.2006.048371.
    1. Liu K., Daviglus M. L., Loria C. M., et al. Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: The Coronary Artery Risk Development in (Young) Adults (CARDIA) study. Circulation. 2012;125(8):996–1004. doi: 10.1161/CIRCULATIONAHA.111.060681.
    1. Golozar A., Khademi H., Kamangar F., et al. Diabetes mellitus and its correlates in an iranian adult population. PLoS ONE. 2011;6(10) doi: 10.1371/journal.pone.0026725.e26725
    1. Chen R., Ovbiagele B., Feng W. Diabetes and stroke: epidemiology, pathophysiology, pharmaceuticals and outcomes. The American Journal of the Medical Sciences. 2016;351(4):380–386. doi: 10.1016/j.amjms.2016.01.011.
    1. Quinn T. J., Dawson J., Walters M. R. Sugar and stroke: Cerebrovascular disease and blood glucose control. Cardiovascular Therapeutics. 2011;29(6):e31–e42. doi: 10.1111/j.1755-5922.2010.00166.x.
    1. Arboix A., Rivas A., García-Eroles L., de Marcos L., Massons J., Oliveres M. Cerebral infarction in diabetes: Clinical pattern, stroke subtypes, and predictors of in-hospital mortality. BMC Neurology. 2005;5(1):p. 9. doi: 10.1186/1471-2377-5-9.
    1. Fox C. S., Golden S. H., Anderson C., et al. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: A scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2015;132(8):691–718. doi: 10.1161/CIR.0000000000000230.
    1. Ley S. H., Hamdy O., Mohan V., Hu F. B. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet. 2014;383(9933):1999–2007. doi: 10.1016/S0140-6736(14)60613-9.
    1. Tziomalos K., Athyros V. G., Karagiannis A., Mikhailidis D. P. Dyslipidemia as a risk factor for ischemic stroke. Current Topics in Medicinal Chemistry. 2009;9(14):1291–1297. doi: 10.2174/156802609789869628.
    1. Sarti C., Kaarisalo M., Tuomilehto J. The relationship between cholesterol and stroke. Implications for antihyperlipidaemic therapy in older patients. Drugs & Aging. 2000;17(1):33–51. doi: 10.2165/00002512-200017010-00003.
    1. Ansell B. J. Cholesterol, stroke risk, and stroke prevention. Current Atherosclerosis Reports. 2000;2(2):92–96. doi: 10.1007/s11883-000-0101-5.
    1. Lee J. S., Chang P.-Y., Zhang Y., Kizer J. R., Best L. G., Howard B. V. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: The strong heart study. Diabetes Care. 2017;40(4):529–537. doi: 10.2337/dc16-1958.
    1. Maaijwee N. A. M. M., Rutten-Jacobs L. C. A., Schaapsmeerders P., van Dijk E. J., de Leeuw F.-E. Ischaemic stroke in young adults: risk factors and long-term consequences. Nature Reviews Neurology. 2014;10:315–325. doi: 10.1038/nrneurol.2014.72.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir