Risk Factors for Stroke in Rural Population of Telangana State of India, an Unmatched Case Control Study

Abstract

Context Stroke tops the list of causes for acquired disability among adults and is the second leading cause of death worldwide. Evidence from developed countries indicate significant decline in stroke incidence and mortality, attributable to prevention of risk factors in general population. There is limited evidence on risk factors for stroke in rural India. Aims This study aims to ascertain the risk factors for stroke in rural Telangana and provide a guide to health care providers in adopting treatment and prevention strategies. Settings and Design The study was conducted in the Moinabad mandal of Ranga Reddy District, Telangana state of India. This is a population based unmatched case–control study. Methods and Materials All the houses of Moinabad were approached by a door-to-door survey to identify cases. A total of 288 persons were enrolled in the study which included 144 cases and 144 controls. Statistical Analysis To derive age and gender adjusted odds ratios of various risk factors, binary logistic regression analysis was performed. Results The estimated crude prevalence of stroke in Moinabad mandal is 257 per lakh population. Modifiable risk factors identified were, total cholesterol, systolic blood pressure, alcohol consumption, smoking, diastolic blood pressure, low high-density lipoprotein cholesterol, and central obesity as measured by waist circumference. Nonmodifiable risk factors identified were male gender and higher age group. Conclusion The high prevalence of stroke in rural Telangana makes it an important public health challenge for the state. The identified risk factors need to be addressed at population level.

Associations of general and central adiposity with hypertension and cardiovascular disease among South Asian populations: a systematic review and meta-analysis

“…The number of participants in included studies varied between 140 and 59 037 24 25. There were 25 (83.3%) included studies in India19 24–47 and three (10%) in Bangladesh 48–50. The remaining two studies were conducted in Mauritian51 and Pakistani52 populations, respectively.…”

“…The remaining two studies were conducted in Mauritian51 and Pakistani52 populations, respectively. The final analyses included two prospective cohort studies (one looking at HTN26 and one looking at CVD mortality51), four case-control studies44–47 (looking at CVD outcomes) and 24 cross-sectional studies19 24 25 27–43 48–50 52 (looking at HTN outcomes). In terms of exposure variables, 29 studies included BMI, 27 studies used WC, 21 studies used WHR and ten studies additionally used other measures, including WHtR (n=6) and hip circumference (n=2).…”

The Distribution of Lifestyle Risk Factors Among Patients with Stroke in the Indian Setting: Systematic Review and Meta-Analysis

“…We have included 61 studies in our systematic review, conducted across various states in India, estimating the various lifestyle risk factors for stroke ( Table 1 ). 13 – 73 Out of 61, 56 studies were conducted and 58 were published after 2000. In 51 studies, patients were enrolled from the hospital-based stroke registries (HBSR) maintained in various treatment settings across India, while in 10 studies, the enrollment was using population-based stroke registries (PBSR).…”

“…The characteristics of the studies included in the meta-analysis are summarized in Table 2 . The meta-analysis included 36 studies, out of which two studies 31 , 66 were multicentric and the remaining included data from various states of the Indian subcontinent (North: 13, 13 , 17 , 20 , 29 , 33 , 39 , 49 , 51 , 54 – 56 , 69 , 61 South: 14, 14 , 19 , 23 , 40 , 45 , 48 , 53 , 59 , 62 , 63 , 65 , 68 , 70 , 71 East: 3, 28 , 36 , 6 West: 2, 47 , 57 and Central: 2 25 , 41 ). The majority of the studies were published in the past decade.…”

“…The majority of the studies were published in the past decade. 13 , 14 , 17 , 19 , 20 , 23 , 25 , 28 , 29 , 31 , 36 , 39 – 41 , 45 , 47 – 49 , 51 , 53 – 57 , 59 Overall, 18,315 stroke patients were included, in which the predominant proportion of subjects were males (64%) compared to females (36%). The mean age of the participants was 53.84 ± 9.3 years.…”