Abstract
The purpose of this study is to investigate and analyze the prevalence and influencing factors of stroke in hypertensive patients aged 60 and above in Jiading District, Shanghai. The population-based study included 18,724 screened people with hypertension (age ≥ 60 years, 48.7% women). From 2016 to 2019, data on demographics, potential influencing factors and health status were collected through face-to-face interviews, physical examinations, and laboratory tests. Logistic multivariate logistic regression model was used to analyze the influencing factors associated with stroke. Among the object of study from 2016 to 2019, 2,025 patients were screened for stroke, with the overall prevalence rate of 10.82% (10.41%-11.23%). Multivariate adjusted model analysis showed that dyslipidemia (OR:1.31,95%CI:1.19-1.45), lack of exercise (OR:1.91,95%CI:1.32-2.76), atrial fibrillation [OR:1.49,95%CI:1.35-1.65), family history of stroke (OR:2.18,95%CI:1.6-2.88) were the significant independent influencing factors of stroke in hypertensive patients over 60 years old. When these four factors were combined, compared with participants without any of these factors, the multi-adjusted odds ratios (95% confidence interval) of risk of stroke for persons concurrently having one, two and three or more of these factors were 1.89 (1.67-2.13), 2.15 (1.86-2.47) and 6.84 (4.90-9.55), respectively (linear trend P < 0.001); after multivariate adjustment, the family history of stroke had additive interaction with lack of exercise [RERI = 1.08(0.22-1.94), AP = 0.19(0.04-0.35), S = 1.31(1.02-1.69)], dyslipidemia [RERI = 0.87(0.41-1.33), AP = 0.23(0.08-0.38), S = 1.46(1.04-2.05)]. The prevalence of stroke was high in hypertensive patients aged 60 and above in Jiading District, Shanghai. Dyslipidemia, lack of exercise, atrial fibrillation and family history of stroke were significantly associated with stroke in hypertensive population. Stroke risk can be increased especially when multiple factors coexisting, and family history of stroke combined with a lack of exercise or dyslipidemia.
Highlights
Stroke is a complex disease affected by many factors, some which may be independent, and may interact with each other
Multivariate adjusted model analysis showed that dyslipidemia (OR:1.31,95%confidence intervals (CI):1.19–1.45), lack of exercise (OR:1.91,95% CI:1.32–2.76), atrial fibrillation [odds ratios (OR):1.49,95%CI:1.35–1.65), family history of stroke (OR:2.18,95%CI:1.6–2.88) were the significant independent influencing factors of stroke in hypertensive patients over 60 years old
Dyslipidemia, lack of exercise, atrial fibrillation and family history of stroke were significantly associated with stroke in hypertensive population
Summary
Stroke is a complex disease affected by many factors, some which may be independent, and may interact with each other. It is important to investigate the factors that influence stroke in hypertensive patients and to implement targeted intervention strategies [3]. Few studies have examined at the interaction between multiple risk factors and stroke, which is important because risk factors often coexist in middle-aged and elderly people [4]. This study has examined the prevalence of stroke, influencing factors and their relationship in hypertensive patients, based on a largescale and high-quality screening program for high-risk population of stroke in Jiading District of Shanghai, in order to provide more evidence for precise intervention required to reduce the risk of stroke. The purpose of this study is to investigate and analyze the prevalence and influencing factors of stroke in hypertensive patients aged 60 and above in Jiading District, Shanghai
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