| Part one The cross- sectional study on risk factors of strokeObjective: To understand the exposure level and distribution characteristics of risk factors of stroke in community population over aged 40 years for the primary prevention of stroke in Chenzhou city.Methods: The target population was selected from Yanquan community of Beihu District and Liangtian town of Suxian District 5100 cases over 40 years old population by cluster sampling and grouped by area.They were investigated face to face with a questionnaire which included general information and common risk factors of stroke. Then grouped by age, gender, urban or rural and whether stroke, describing exposure rate of risk factors and its distributional characteristics of area and population.Result: 5100 individuals were enlisted into data analysis, including 2100 citizens and 3000 villagers. The youngest was 40 years old, theoldest was 93 years old, the average age(56.3±11.064).Among them 2360 are male, accounted for 46.3% of the survey population, the average age(56.23±11.008), 2740 are female,the average age(56.36±11.113), accounting for 53.7% of the surveyed population.The population of stroke 172, accounting for 3.3% of the surveyed population.The exposure rate of hypertension,dyslipidemia, diabetes, atrial fibrillation, smoking, poverty of movement, obesity, high salt diet and family history of stroke were 24.5%, 9.5%, 12.3%, 0.8%, 16.7%, 9.1%, 14.5%, 28.2% and 4.6%, respectively. In city, the exposure rate of hypertension, dyslipidemia, diabetes, atrial fibrillation, smoking, poverty of movement, obesity high salt diet and family history of stroke were 25.7%, 13.3%, 13.0%, 1.3%, 18.9%, 8.3%, 13.4%, 24.8% and 6.0%, respectively.In rural, the exposure rate of hypertension, dyslipidemia, diabetes, atrial fibrillation, smoking, poverty of movement, obesity high salt diet and family history of stroke were 23.7%, 6.8%, 11.8%, 0.5%, 15.2%, 9.6%, 15.4%, 30.5% and 3.7%, respectively. In City people the exposure rate of dyslipidemia, atrial fibrillation, smoking and family history of stroke were higher than those of in rural, there were significant differences between areas for all factors. City high salt diet exposure rate is lower than the rural exposure rate, and there were significant differences(P<0.05). Among different age groups of hypertension, dyslipidemia and poverty of movement exposure rate is correlated with age(P<0.05). Among them, poverty of movement andhypertension exposure rate increased along with the age growth, dyslipidemia in the age group of exposure rate has no obvious regularity. hypertension exposure rate in male is higher than the exposure rate of hypertension in women. The exposure rate of hypertension, dyslipidemia, atrial fibrillation, smoking, poverty of movement, high salt diet and overweight are higher than the group of no stroke, the difference has statistical significance(P<0.05).Conclusions:Stroke prevalence rate was 3.3% in the population over aged 40 years in Chenzhou city. Higher exposure rate risk factors of stroke in community population over 40 years old in Chenzhou city are high salt diet, hypertension and smoking.The urban people should pay more attention to control dyslipidemia, the rural people should change habits of high salt diet. Hypertension becomes the primary risk factors of stroke in males. Hypertension, dyslipidemia, poverty of movement and high salt diet are main risk factors to prevent stroke recurrence.Part two Analysis of risk factors of stroke interventionObjective: To understand and analysis the drug treatments for stroke, drug discontinuance reason, and life style as well as treatment compliance changes before and after stoke, provide references for implementation of secondary prevention of stroke in Chenzhou city.Methods: The target population were selected the stroke population who screened in the first part, and intervening and monitoring their chronic diseases and bad habits, 1 year later, using Stroke Behavior Change Inventory(SBCI) to detect the patients before and after stroke risk behavior change. This table includes two aspects of drug compliance and living habits, to meet for the first time the medication record information and way of life as the baseline, after 1 years of follow-up: record the use of antihypertensive drugs in patients with chronic disease, hypoglycemic and antilipemic agents, and bad habits of the lack of exercise, smoking and high salt diet change, these 6 results by recording four points scoring method(see Table 1).Note: the chronic diseases including hypertension, diabetes and dyslipidemia, the definition are same as the first part.Result: Effective in 160 cases were followed up, the mean age was(54.33±8.690) years old, the oldest was 79 years old, the youngest was 40 years old. Antihypertensive drug compliance was 78.2%, hypoglycemic drug compliance was 78.9%, lipid drug compliance was 47.5%. Respectively antihypertensive drugs, antidiabetic drug and lipid drug withdrawal is the main reason for the thought with no symptoms(50%), do not understand the medication time(62.5%), since that has no symptoms(49.1%).Unhealthy living habits to improve differences were strengthening exercise(0.56±1.02), low salt diet(1.36±1.38) and smoking(0.53±0.98). The behavior of drug compliance changedifferences were taking antihypertensive drugs(1.51±1.44), hypoglycemic agents(0.98±1.32) and lipid drug(0.53±1.31), and there were significant indicators of the degree of change(P < 0.001).Conclusion:The bad habits and behavior of drug compliance with stroke patients in Chenzhou improved after intervention. |
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