A Cohort Study on The Primary Prevention of Stroke Incidence in Adult Population in Bogor, West Java

Abstract

ABSTRACT Background: Incidence of stroke showed an increasing trend in Indonesia, 12 new cases per 1,000 in 2013, and 19 new cases per 1,000 in 2018 despite the stroke control programs from the government. This study aimed to estimate Cumulative Incidence, Incidence Rate, and Population Attributable Fraction (PAF). This study also estimated the effect of blood pressure, physical activity, blood sugar levels, and smoking habits on the risk of stroke in adults. Subjects and Method: This was a cohort study conducted for 6 years in 5 Districts, Bogor City, West Java. An adult population of 5,189 subjects with aged ≥25 years was selected. The dependent variable was stroke. The independent variables included blood pressure, physical activity, blood sugar level, and smoking habits. Data for independent variables (except blood sugar level) were collected by using questioners. Data were analyzed by Cox Proportional Hazard Model. Results: The Cumulative Incidence was 2.09% and Incidence Rate was 480 new stroke cases per 100,000 person-year (CI 95%= 130 to 670) over 6 years. Predictors of stroke incidence were hypertension (HR= 2.50; CI 95%= 1.50 to 4.10; p= 0.001), low physical activity (HR= 2.40; CI 95%= 1.50 to 3.90; p< 0.001), high blood sugar level (HR= 3; CI 95%= 1.70 to 5.50; p= 0.001), and heavy smoking (HR= 3.90; CI 95%= 1.40 to 11.10; p= 0.007). PAF of blood sugar level and physical activity was 67.75%, and able to reduce stroke incidence by 1,990 from 2,937. Conclusion: Hypertension, low physical activity, high blood sugar level, and heavy smoking are predictors of stroke in adult. Primary prevention by increasing physical activity and decreasing blood sugar level can reduce incidence of stroke. Keywords: stroke, Cumulative Incidence, Incidence Rate, PAF, primary prevention Correspondence: Woro Riyadina. National Institute of Health Research and Development, Ministry of Health, Indonesia. Email: w.riyadina02@gmail.com. Mobile: +6281297673074. DOI: https://doi.org/10.26911/the7thicph.01.25