Abstract
Stroke is a significant cause of death and disability. In Thailand, it imposes a major health burden, and the prevalence of stroke is increasing, particularly in patients with hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP). We aimed to determine the trends in the prevalence of stroke and the associated factors among Thai patients with HT. Nationwide cross-sectional studies were conducted annually in 2014, 2015 and 2018 based on data obtained from the Thailand DM/HT study. Nationally, representative patients with HT in Thailand were sampled with stratified one-stage cluster sampling. A total of 104,028 participants were included in this study. The prevalence of stroke remained constant, with prevalence rates of 4.0%, 3.8%, and 3.9% in 2014, 2015 and 2018, respectively (p for trend = 0.221). Our findings suggested that the management of stroke patients who are covered by the universal coverage scheme should be evaluated. Effective interventions, including promoting smoking cessation, attenuating cholesterol levels, and controlling blood pressure should be provided to hypertensive patients to prevent ischemic stroke. Young adults with HT should be more concerned about the possibility of stroke. The use of prophylactic low-dose aspirin should be carefully monitored to prevent hemorrhagic stroke.
Highlights
Stroke is a significant cause of death and disability
Abbreviations HT Hypertension diabetes mellitus (DM) Diabetes mellitus DLP Dyslipidemia body mass index (BMI) Body mass index atrial fibrillation (AF) Atrial fibrillation odds ratios (ORs) Crude odds ratio adjusted odds ratios (AORs) Adjusted odds ratio relative risk (RR) Relative risk 95% confidence interval (95% CI) 95% Confidence interval
In Thai patients with HT, we found that the prevalence of both ischemic (Table 3) and hemorrhagic strokes (Table 4) was higher in patients who were admitted to regional and provincial hospitals than in those admitted to community hospitals
Summary
Stroke is a significant cause of death and disability. In Thailand, it imposes a major health burden, and the prevalence of stroke is increasing, in patients with hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP). Based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 20172, the age-standardized incidence of patients with stroke declined by 11% (from 0.17 to 0.15%) worldwide from 1990 to 20173. This decline may have resulted from more aggressive control of the risk factors through the adoption of preventive measures. We aimed to determine the prevalence of stroke in Thai patients with HT visiting the Ministry of Public Health and Bangkok Metropolitan Administration Hospitals from 2014 to 2018 based on information from the Thailand Diabetes Mellitus/Hypertension (DM/HT) database and identify the associated factors.
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