Stroke at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a cross-sectional analysis

Abreu, Fernanda Gabriela de; Goulart, Alessandra Carvalho; Birck, Marina Gabriela

doi:10.1590/1516-3180.2018.0129060818

Cited by 4 publications

(7 citation statements)

References 33 publications

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“…In the most chronic diseases, income-related inequalities in China was basically consistent with that in other countries, including diabetes, 14 cancer, 14 arthritis, 20 and emotional problem. 21,22 However, some of the results were contrary to other counties, including heart problem, stroke, 23 and memory-related problems. 24 Taking heart problem as an example, this study indicated that, the medium-income Chinese population aged 45 to 59 years had a higher risk of prevalence than the low-income population.…”

Section: Discussionmentioning

confidence: 88%

Income-Related Inequalities in Chronic Disease Situation Among the Chinese Population Aged Above 45 Years

Qin

Zirui

Ding

2019

INQUIRY

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There is relatively little published on the socioeconomic distribution of chronic disease burden in older people. This study aims to quantify income-related inequalities in chronic disease situation among ≥45-year-old people in China. Data were collected from the 2015 China Health and Retirement Longitudinal Study. Self-reported chronic conditions included 14 diseases (ie, heart problem, diabetes). Multivariate Generalized Quasi-Poisson Regression was used to evaluate associations between prevalence and personal income. Prevalence of hypertension was highest among people above ≥ 75 (male participants 44.41%, female participants 47.53%). Heart problem prevalence increased with age. Chronic disease prevalence among population aged 45 to 59 years was greatly affected by income. Prevalence ratios (PRs) were highest for heart problems in 45 to 59 middle-income male participants and for memory-related diseases in 45 to 59 middle-income female participants. Significant inequalities in chronic conditions prevalence persist into old age, particularly among 45- to 59-year-old people. Opposite to developed countries, the prevalence of some chronic disease (ie, heart problem) is higher in richer populations in China. These findings pose the policy challenge of needing to prevent such inequalities in older years.

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Section: Discussionmentioning

confidence: 88%

Income-Related Inequalities in Chronic Disease Situation Among the Chinese Population Aged Above 45 Years

Qin

Zirui

Ding

2019

INQUIRY

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“…12 In low-middle income countries, including Brazil, the more difficult access to specialized medical treatment, rehabilitation services, and the lack of medication adherence impacts on the overall burden of stroke, particularly mortality. [14][15][16] Although there are initiatives to improve patient knowledge regarding AF and OAC therapy in high-income countries 17,18 almost nothing was done in low-and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

The impact of atrial fibrillation and long-term oral anticoagulant use on all-cause and cardiovascular mortality: A 12-year evaluation of the prospective Brazilian Study of Stroke Mortality and Morbidity

Goulart

Olmos

Santos

et al. 2021

International Journal of Stroke

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Background: Atrial fibrillation (AF) is a predictor of poor prognosis after stroke. Aims: To evaluate AF and all-cause and cardiovascular (CVD) mortality in a stroke cohort with low socioeconomic status (SES), taking into consideration oral anticoagulant (OAC) use during 12-year follow-up. Methods: All-cause mortality was analyzed by Kaplan-Meier survival curve and Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (95%CI). For specific mortality causes, cumulative incidence functions were computed. A logit link function was used to calculate odds ratios (OR) with 95% CIs. Full models were adjusted by age, sex, OAC use (as a time-dependent variable) and cardiovascular risk factors. Results: Of 1,121 ischemic stroke (IS) participants, 17.8 % had AF. Overall, 654 deaths (58.3%) were observed. Survival rate was lower (median days, interquartile range-IQR) among those with AF (531, IQR: 46-2,039) vs. non-AF (1,808, IQR: 334-3,301), p-log rank <0.0001). Over 12-year follow-up, previous AF was associated with increased mortality: all-cause (multivariable HR, 1.82; 95%CI: 1.43-2.31) and CVD mortality (multivariable OR, 2.07; 95%CI: 1.36-3.14), but not stroke mortality. In the same multivariable models, OAC use was inversely associated with all-cause mortality (OAC time-dependent effect: multivariable HR, 0.47; 95%CI: 0.30-0.50, p=0.002) and stroke mortality (OAC time-dependent effect â¥ 6 months: multivariable OR, 0.09; 95% CI: 0.01-0.65, p-value=0.02), but not CVD mortality. Conclusions: Among individuals with low SES, AF was an independent predictor of poor survival, increasing all-cause and CVD mortality risk. Long-term OAC use was associated with a markedly reduced risk of all-cause and stroke mortality.

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“…9 ELSA-Brasil also presented important data correlating the use of medication for secondary prevention with socioeconomic status. In both studies, 6,7 the use of secondary prevention was higher among participants with high socioeconomic status than among participants with low socioeconomic status. One crucial point needs to be noted here: the sample for ELSA-Brasil comprised civil servants with high educational attainment and monthly family income, compared with the general population in Brazil.…”

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confidence: 83%

“…5 Recent data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) have presented similar results. 6,7 ELSA-Brasil is a prospective cohort study of 15,105 civil servants in six cities in Brazil (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo and Vitória).…”

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confidence: 99%

“…Moreover, both studies highlighted a critical point: secondary prevention was less used among women than among men. 6,7 This lack of secondary cardiovascular prevention is not a scientific secret, and also it is not an exclusively Brazilian problem. Some other studies have shown lower frequency of use of medication for secondary prevention of cardiovascular disease among women than among men.…”

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confidence: 99%

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Stroke at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a cross-sectional analysis

Abstract: BACKGROUND: Secondary prevention of stroke is a very important goal for achieving continuous reduction in stroke mortality rates over the next decades. DESIGN AND SETTING: Cross-sectional analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), with data from Salvador,

Cited by 4 publications

References 33 publications

Income-Related Inequalities in Chronic Disease Situation Among the Chinese Population Aged Above 45 Years

Income-Related Inequalities in Chronic Disease Situation Among the Chinese Population Aged Above 45 Years

The impact of atrial fibrillation and long-term oral anticoagulant use on all-cause and cardiovascular mortality: A 12-year evaluation of the prospective Brazilian Study of Stroke Mortality and Morbidity

Secondary prevention of cardiovascular disease in Brazil: lessons from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

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