Incidence And Risk Factors Of Stroke In Rural Residents Of Tianjin

PurposeTo explore the incidence and risk factors of stroke and its subtypes in low-income and low-education populations in rural residents China,and provide a theoretical basis for prevention and intervention of stroke in rural areas.MethodsThe incidence of stroke in this population was regularly reported by local township doctors,and then the neurologists from the General Hospital of Tianjin Medical University according to the clinical symptoms and imaging examination of stroke patients,divided the patients into: ischemic stroke,hemorrhagic stroke and undetermined type.Follow-up was completed until February 2018.The incidence of stroke and its subtypes during the follow-up period were statistically analyzed and the differences in demographic data,past medical history,and lifestyle between stroke and non-patients of each sub-type were compared.Cox regression analysis was used to estimate the hazard ratio of each relevant factor to stroke and its sub types.All possible risk factors were adjusted during the analysis to identify risk factors that may be associated with stroke and its sub types;Gender and age stratification were performed on relevant influencing factors to analyze differences in risk factors for stroke and its sub-types among people of different ages and genders.ResultsIn this study,a total of 638 cases of stroke were found during 28 years of follow-up,including 404(63.3%)cases of ischemic stroke and 121(19.0%)cases of hemorrhagic stroke.The annual incidence of stroke in the study cohort was 747.54 per 100,000 person-years,with an ischemic stroke of 473.36 per 100,000person-years and a hemorrhagic stroke of 141.77 per 100,000 person-years.Multivariate analysis showed that the risk of male stroke and its subtypes was higher in all age groups than in women(P<0.05).In men and women,the risk of stroke and its subtypes increased with age(P<0.05).In the population aged<65 years old,theincrease in education level was a protective factor for the total stroke and its subtypes compared with illiterate(P<0.05).In the general population,the risk of total stroke and ischemic stroke was increased in abstinence patients compared with those who did not drink(P<0.05).In men aged <45 years,heavy drinking was a risk factor for the total stroke and ischemic stroke(P<0.05);in men aged 45-64 years,alcohol consumption was a protective factor for stroke and its sub types(P<0.05),and light and high alcohol consumption were protective factors for total stroke and ischemic stroke(P<0.05).In the population age <65 years of age,hypertension was a risk factor for total stroke and its subtypes compared with those without hypertension,and the risk increased with increasing blood pressure(P<0.05).Among the population age?65 years,grade 3 hypertension was a risk factor of total stroke both in men and women,and of hemorrhagic stroke for men(P<0.05).In the population aged<65years,overweight was a risk factor for total stroke and its subtypes,and underweight was a risk factor for hemorrhagic stroke in men(P<0.05).And overweight was a risk factor for total stroke and it subtypes,underweight was a risk factor for total and ischemic stroke in women(P<0.05).However,among people over 65 years old,education,alcohol consumption,alcohol degree,and BMI were not associated with stroke and its subtypes(P>0.05).ConclusionThis study is a prospective cohort study of the incidence and risk factors of stroke and its subtypes in rural Chinese.The results of the study showed that the annual incidence of stroke in the study population was as high as 747.54/100,000person-years.Gender,age,education level,drinking history,hypertension,and high BMI are risk factors for stroke and its subtypes.Especially in young and middle-aged men,these risk factors have a more pronounced effect on the onset of stroke.Therefore,different stroke prevention measures should be proposed for people of different ages and genders,and our future key prevention population should be placed on young and middle-aged people,especially men,to control risk factors and reduce the burden of stroke.