Prevalence and risk factors for stroke in a population of Southern Brazil

Abstract

Stroke is the leading cause of death in many countries of Latin America. Population studies are necessary in this region.Objectives:To evaluate the prevalence of stroke and its risk factors in a population of vulnerable communities of southern Brazil.Methods:Population-based crosssectional study with systematic sampling. Individuals aged 20 and over were included (n=3,391). Individuals with previous diagnosis of stroke or identified by a validate stroke questionnaire were compared with those without stroke in many variables.Results:285 individuals (8.4%) had previous stroke. The group without stroke showed greater average of years of study than the group with stroke (p≪0.001). Multivariable analysis identified as risk factors for stroke (p≪0.05): age from 40 to 59, age from 60 to 79, widowhood, present smoking, previous smoking, hypertension and ischemic heart disease.Conclusion:The findings in this population indicate the need of preventive cost-effective public health policies in Brazil.

Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends

“…Pooled estimate of stroke in upper-middle-income countries is about 3-fold higher as against lower-middle-income or low-income countries. These differences are not surprising, however, the increasing levels of affluence and urbanization [30] and the rise in life expectancy [30] and associated risk factors [4,25] particularly hypertension provide a plausible explanation. In fact, there is a large body of epidemiological evidence on the high prevalence of undetected or poorly managed hypertension in LMICs, which is likely to play a major role in the huge prevalence of stroke in these settings [25].…”

Prevalence of stroke and associated disability in Brazil: National Health Survey - 2013

“…In the study of Copstein et al performed in the city of Porto Alegre (South region), although it was not found statistically significant differences in the prevalence of cerebrovascular disease among men and women, some characteristics were identified as risk factors for stroke such as age, widowhood, smoking, hypertension, coronary heart disease and low education 12 .…”

“…However, the decrease in stroke mortality is not equally distributed across the country and it occurs mainly on the poorest areas of the country and among Blacks 5,6,7 . Compared to previous mortality studies 8 , there are few studies evaluating the prevalence of stroke in Brazil according to sociodemographic characteristics 9,10,11,12 . These studies were carried out in cities or isolated regions reflecting more local realities than a national panorama of the disease.…”

“…Also, a higher frequency of stroke in women (4.1%) compared to men (3.0%) in the urban area was found, but no differences according to gender in rural area of Coari was reported 11 . Another population-based study conducted in 3,391 individuals in the urban area of Porto Alegre (South region of Brazil) revealed a stroke prevalence of 8.4% detected by previous self-reported diagnosis or a questionnaire about symptoms of stroke 12 . Most of these studies assessed the prevalence of stroke in areas covered by the Health Family Program 9,10,11 .…”

“…Most of these studies assessed the prevalence of stroke in areas covered by the Health Family Program 9,10,11 . Differences in numbers between the four studies can be explained by local characteristics and the different diagnostic strategies, which were based on the medical diagnosis 9 or validated stroke questionnaire 10,11,12 . The paucity of stroke data in the country, especially on the national scene, makes the National Health Survey (Pesquisa Nacional de Saúde-PNS) applied in 2013, a unique opportunity to describe the self-declared prevalence of stroke in Brazilian population (≥ 18 y-old) with representation for the whole country, including urban and rural areas, according to sex, race/self-reported skin color, education level and occupation.…”