Abstract
With the aging of the population and the change of lifestyle in China, the prevalence and risk factors of the high-risk population for stroke may change. However, few studies performed community-based high-risk stroke population surveys in China. Hence, we performed this multicenter, cross-sectional, and community-based survey in Sichuan of southwestern China, according to the China National Stroke Screening Survey (CNSSS) program in 2015. The residents aged ≥ 40 years volunteered to participate in the face-to-face survey in 8 communities in Sichuan. The 8 communities were selected using the cluster randomization method. Subjects with at least three of the eight stroke-related risk factors were classified as a high-risk population for stroke. Otherwise were classified as a low-risk population for stroke. Furthermore, 1,011 individuals were randomly selected among the low-risk population for stroke as controls. Among 16,892 participants, 2,369 (14.0%) were high-risk population for stroke. After full adjustments, all eight risk factors for stroke were significantly associated with the high-risk population for stroke (P < 0.001). The largest contributor was hypertension [population-attributable risk (PAR) 28.4%], followed by physical inactivity (PAR 14.2%), dyslipidemia (PAR 11.2%), overweight/obesity (PAR 9.4%), diabetes (PAR 7.2%), family history (PAR 6.8%), smoking (PAR 5.9%), and atrial fibrillation (PAR 3.5%). Carotid atherosclerosis was more serious in the high-risk population for stroke than in controls (P < 0.05). The prevalence of the high-risk population for stroke was high in southwestern China. Hypertension, physical inactivity, and dyslipidemia were stronger contributors for the high-risk population for stroke. Individual-level and population-level interventions for these leading risk factors are very important for the primary prevention of stroke.
Highlights
IntroductionIn the past four decades, the incidence of stroke has decreased because of effective strategies for preventing stroke risk factors and good healthcare services in developed countries
Stroke is the leading cause of death and disability in China [1–3]
The results showed that the prevalence of all eight risk factors and levels of TC, TG, and low-density lipoprotein cholesterol (LDL-C) were significantly higher in the high-risk population for stroke than the low-risk population for stroke
Summary
In the past four decades, the incidence of stroke has decreased because of effective strategies for preventing stroke risk factors and good healthcare services in developed countries. China has experienced rapid sociodemographic changes and health transitions in the past three decades; these may result in changes in the prevalence of traditional risk factors for stroke [2, 5]. There was a large increase in the prevalence of hypertension, smoking, overweight, dyslipidemia, diabetes mellitus, physical inactivity, diets low in fruit and vegetables, and high sodium intake [6–11]; these are the most common and modifiable risk factors for stroke and all of these may affect stroke burden in China [12]. Hypertension is the most important risk factor for stroke, and it was substantially increased in the past four decades in China [13]. Large prospective studies revealed that lifestyle (physical inactivity and smoking) and dietary habits (such as high salt intake) were associated with the risk of stroke [6, 12]
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