| Objective: Along with the growth of aging population in China,the stroke of the elderly has imposed a heavy burden on the patients,their families and the entire country.The purpose of our study is to investigate the elderly inhabitants in two areas at different altitudes(high-altitude area: Shangxinzhuang Town,Huangzhong County,Qinghai Province;and low-altitude area: Linshengbao Town,Sujiatun District,Shenyang City,Liaoning Province)and find out their differences in the prevalence and influencing factors of stroke.It aims to propose theoretical basis for the formulation of prevention and control strategies for stroke in different regions.Methods: In the cross-sectional study,cluster sampling method was used to collect the data of physical examinations of the elderly inhabitants in Shangxinzhuang Town,Huangzhong County,Qinghai Province,and the screening data of the elderly inhabitants who were screened for high-risk strokes in Linshengbao Town,Sujiatun District,Shenyang City,Liaoning Province from March to July 2017.The prevalence and influencing factors of stroke in the two areas were then analyzed.The data of Shangxinzhuang Town were used to analyze whether there were differences in the prevalence and influencing factors of stroke among different ethnic groups.Then,the data of the elderly Han Chinese in the two areas were compared and analyzed.Finally,the impact of the resident plateau on the risk of stroke was analyzed.Results:A total of 1,600 cases from Shangxinzhuang Town(including 979 cases of Han Chinese,378 cases of Tibetans,and 243 cases of Hui people)and a total of 452 cases from Linshengbao Town(all Han Chinese)were included for analysis.1.The crude prevalence rate of stroke among the elderly in Shangxinzhuang Town was 2,937.5/100,000,while the crude prevalence rate of stroke among the elderly Han Chinese in Linshengbao Town was 11,283.2/100,000.The comparison of the standardized prevalence rate of stroke among the elderly Han Chinese in the two areas showed that: the standardized prevalence rate of stroke among the elderly men in Linshengbao Town and Shangxinzhuang Town was 16,121.1/100,000 and3,536.1/100,000,respectively;and the rate among the elderly women in Linshengbao Town and Shangxinzhuang Town was 7,115.2/100,000 and 2,532.5/100,000,respectively.2.By comparing the demographic and clinical data of the elderly in Shangxinzhuang Town(grouped according to whether they had a history of stroke),the single-factor analysis indicated that the constituent ratio of hypertension and high-altitude polycythemia and the systolic blood pressure in the stroke group were significantly different from those in the non-stroke group(P<0.05).The multiple-factor analysis indicated that the constituent ratio of hypertension(OR 2.634,95%CI 1.068~6.492;P=0.035)had statistically significant differences.The standardized prevalence rates of stroke among the elderly of Han Chinese,Tibetans and Hui people were349,5.3/100,000,294,57/100,000 and 123,01/100,000,respectively.The single-factor analysis based on different ethnic groups showed significant differences in age,educational background,smoking rate,rate of overweight or obesity,systolic blood pressure,diastolic blood pressure,total cholesterol,hemoglobin,body mass index,and the constituent ratio of hypertension,hypercholesterolemia and high-altitude polycythemia among the elderly from different ethnic groups(P<0.05).3.By comparing the demographic and clinical data of the elderly Han Chinese in Linshengbao Town(grouped according to whether they had a history of stroke),the single-factor analysis indicated that male,smoking,family history of stroke,proportion of hypertriglyceridemia and diastolic blood pressure in the stroke group were significantly different from those in the non-stroke group(P<0.05).The multiple-factor analysis indicated that male(OR 2.179,95%CI 1.117~4.251;P=0.022)and family history(OR 2.215,95%CI 1.145~4.285;P=0.018)of stroke had statistically significant differences.4.A comparative analysis showed that the elderly Han Chinese in the two areas had significant differences in age,marital status,education background,hypertension,hypertriglyceridemia,hypercholesterolemia,proportion of overweight or obesity,systolic blood pressure,diastolic blood pressure and body mass index(P<0.05).5.The multiple-factor analysis of influencing factors of stroke in the elderly in general study population(including the research population of Shangxinzhuang Town and Linshengbao Town)showed significant differences in the proportion of male(OR1.977,95%CI 1.178~3.319;P=0.010),hypertension(OR 2.342,95%CI 1.066~5.142;P=0.034),and permanent residents at high altitude(OR 0.301,95%CI 0.175~0.516;P<0.001)between the stroke group and the non-stroke group.Conclusion:1.The prevalence of stroke among the elderly Han Chinese in Linshengbao Town,Sujiatun District,Shenyang City,regardless of the gender,is higher than that in Shangxinzhuang Town,Huangzhong County,Qinghai Province.2.Among the elderly in Shangxinzhuang Town,the constituent ratio of hypertension and high-altitude polycythemia and the systolic blood pressure in the stroke group are significantly higher than those in the non-stroke group.Hypertension is an independent risk factor for stroke of the elderly in Shangxinzhuang Town;among the elderly Han Chinese in Linshengbao Town,the factors including male,smoking,family history of stroke,proportion of hypertriglyceridemia and diastolic blood pressure in the stroke group are significantly higher than those in the non-stroke group.Male and family history of stroke are the independent risk factor for stroke of the elderly Han Chinese in Linshengbao Town.3.The risk of stroke in the elderly Han population who live in low-altitude areas(Linshengbao Town)is 3.32 times that of the elderly Han population who live in high-altitude areas(Shangxinzhuang Town).There are differences in the prevalence and influencing factors of stroke among the elderly in Han Chinese,Tibetans and Hui people in Shangxinzhuang Town,there are also differences among the elderly in Shangxinzhuang Town and Linshengbao Town.So,the prevention and control program of stroke should be formulated for different regions and different ethnic groups. |
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