Screening of stroke risks among middle-aged and elderly people in Shanghai community general outpatient clinics

Abstract

Objective To screen stroke risks among middle-aged and elderly people in community outpatient clinics in Shanghai. Methods A stroke risk screening was conducted among people aged 45-75 years selected with convenient sampling method from 10 community health service centers in Putuo district, Yangpu district and Pudong New Area of Shanghai during January to July 2017. The questionnaire and clinical measurement were used for screening. Multivariate logistic regression analysis was used to analyze the risk factors in subjects with high stroke risk. Results In this study, 1 094 individuals with high stroke risk were screened out from 1 750 participants (62.5%). The proportion of high risk cases was higher among men (66.7%, 473/709) than that among women (59.7%, 621/1 041) , unmarried, divorced or widowed (75.0%, 90/120) than married or cohabitants (61.6%, 1 004/1 630) , living alone (72.1%, 70/97) than living with others (61.9%, 1 024/1 653) (χ2=8.969, 8.571, 4.081; P<0.01). Compared with non-high-risk subjects, the high-risk subjects had higher BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycated hemoglobin, total cholesterol, triglycerides, serum creatinine and homocysteine, and were more likely to have carotid plaques or stenosis, the difference was statistically significant (P<0.05). Multiple logistic regression analysis showed that unmarried/divorce/widowed, high BMI, systolic blood pressure, fasting blood glucose, total cholesterol, and carotid plaque or stenosis were positively associated with high stroke risk(OR=2.015, 1.173, 1.013, 1.456, 1.139, 1.026, 2.103; P<0.05). Conclusions The proportion of high stroke risk individuals among middle-aged and elderly people is higher in community general practice outpatient clinics in Shanghai. Patients with high BMI, systolic blood pressure, fasting blood glucose and total cholesterol, and carotid plaque or stenosis, as well as those unmarried/divorced/widower should be the subjects for stroke intervention. Key words: Stroke; Middle-aged and elderly; Community health center; High risk