Prevalence Of Self-reported Stroke Research Articles

Trends in American Indian/Alaskan native self-reported stroke prevalence and associated modifiable risk factors in the United States from 2011-2021

BackgroundStroke prevalence varies by race/ethnicity, as do the risk factors that elevate the risk of stroke. Prior analyses have suggested that American Indian/Alaskan Natives (AI/AN) have higher rates of stroke and vascular risk factors. MethodsWe included biyearly data from the 2011-2021 Behavioral Risk Factor Surveillance System (BRFSS) surveys of adults (age ≥18) in the United States. We describe survey-weighted prevalence of stroke per self-report by race and ethnicity. In patients with self-reported stroke (SRS), we also describe the prevalence of modifiable vascular risk factors. ResultsThe weighted number of U.S. participants represented in BRFSS surveys increased from 237,486,646 in 2011 to 245,350,089 in 2021. SRS prevalence increased from 2.9% in 2011 to 3.3% in 2021 (p<0.001). Amongst all race/ethnicity groups, the prevalence of stroke was highest in AI/AN at 5.4% and 5.6% in 2011 and 2021, compared to 3.0% and 3.4% for White adults (p<0.001). AI/AN with SRS were also the most likely to have four or more vascular risk factors in both 2011 and 2021 at 23.9% and 26.4% compared to 18.2% and 19.6% in White adults (p<0.001). ConclusionFrom 2011-2021 in the United States, AI/AN consistently had the highest prevalence of self-reported stroke and highest overall burden of modifiable vascular risk factors. This persistent health disparity leaves AI/AN more susceptible to both incident and recurrent stroke.

Effect modification of age and hypertension on cancer and prevalence of self-reported stroke - A cross-sectional study.

The objective of this study was to examine the effect modification of age on the relationship between cancer and prevalence of self-reported stroke. We used cross-sectional data from the 2015-2016 iteration of the Canadian Community Health Survey. A multivariable logistic regression model was used to assess the association between cancer and self-reported stroke. Covariates were assessed for effect modification using the maximum likelihood estimation method. We analyzed 86,809 subjects; the prevalence of self-reported stroke was 1.11%. The odds ratio for the association between cancer and self-reported stroke was 1.26 (95% CI 0.98-1.61) after adjusting for age, sex, dyslipidemia, hypertension, diabetes, heart disease, education, and household income. Age and hypertension were found to be effect modifiers, and the association between cancer and self-reported stroke was stronger in younger adults and in those without hypertension. These results suggest that cancer-associated strokes may have unique underlying mechanisms compared to conventional strokes.

Abstract 15289: Association Between Liver Stiffness and Prevalence of Stroke: Analysis of the National Health and Nutrition Examination Survey 2017 - 2020

Introduction: While cirrhotic patients increase risk of hemorrhagic and thrombotic events, association of liver stiffness with stroke remaines unclear. Hypothesis: Severity of liver stiffness is associated with higher prevalence of stroke. Methods: A cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2017 to March 2020 included adult participants aged 21 to 79 years. Association between prevalence of self-reported stroke and liver stiffness stratified for 4 fibrosis scores measured by Fibroscan ™ were analyzed by multivariate logistic regression. Results: A total of 8,416 patients with Fibroscan results were identified (mean age 49 + 16 years old; 52% female; 32% white). Overall, 377 patients (4.5%) had a stroke. The number of participants stratified by 4 fibrotic stages of mild (F0F1), moderate (F2), severe fibrosis (F3), and cirhosis (F4) were 6,243 (74.2%), 826 (9.8%), 122 (1.4%), and 155 (1.8%) patients, respectively. In multivariate logistic regression, after controlling for age, race, gender, diabetic status, body mass index (&lt;25 vs &gt; 25 kg/m 2 ), and high systolic blood pressure ( &lt; 130 vs &gt;130 mmHg), individuals with severe fibrotic liver (F3 and F4) were significantly more likely to have a stroke (adjusted odds ratio (OR) 1.64; p= 0.044; 95% confidence interval (CI) 1.01, 2.65; Figure 1). Furthermore, we found that patients with cirrhosis (F4) were the most at risk to have a stroke (adjusted OR 1.91; p= 0.037; 95% CI 1.04, 3.49; Figure 1). Conclusions: In this cross-sectional data, there is a graded association between severe fibrotic liver disease measured by Fibroscan ™ and elevated prevalence of stroke. Longitudinal studies including additional risk factors of stroke such as hyperlipidemia, hypertension and atrial fibrillation need to be further evaluated.

Residential exposure to petroleum refining and stroke in the southern United States

BACKGROUND AND AIM: The southern United States (U.S.) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the U.S. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollutants implicated in stroke pathogenesis. The relationship between residential PPR exposure and stroke has not been studied. We aimed to investigate the census tract-level association between residential PPR exposure and stroke prevalence for adults (&amp;#x2265;18 years) in seven southern U.S. states in 2018. METHODS: We conducted spatial distance- and generalized propensity score-matched analysis that adjusts for sociodemographic factors, smoking, and unmeasured spatial confounding. PPR was measured as inverse-distance weighted averages of petroleum production within 2.5km or 5km from refineries, which was strongly correlated with measured levels of sulfur dioxide, a byproduct of PPR. RESULTS: The prevalence of self-reported stroke ranged from 0.4% to 12.7% for all the census tracts of the seven states. Hispanic population and people with low socioeconomic status resided closer to petroleum refineries. The non-Hispanic Black population was exposed to higher PPR, while non-Hispanic White population was exposed to lower PPR. Residential PPR exposure was significantly associated with stroke prevalence. One standard deviation increase in PPR within 5km from refineries was associated with 0.20 (95% confidence interval: 0.08, 0.33) percentage point increase in stroke prevalence. PPR explained 5.5% (2.1, 9.0) of stroke prevalence in the exposed areas. These values differed by states: 1.0% (0.4, 1.7) in Alabama to 11.1% (4.2, 17.9) in Mississippi, and by census tract-level: 0.08% (0.02, 0.12) to 23.8% (9.0, 38.6). CONCLUSIONS: PPR is associated with self-reported stroke prevalence, suggesting possible links between pollutants emitted from refineries and stroke. The increased prevalence due to PPR may differ by sociodemographic factors. Keywords: Stroke Belt; Oil industry; Environmental justice

Residential exposure to petroleum refining and stroke in the southern United States

The southern United States (US) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the US. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollutants implicated in stroke pathogenesis. The relationship between residential PPR exposure and stroke has not been studied. We aimed to investigate the census tract-level association between residential PPR exposure and stroke prevalence for adults (⩾18 years) in seven southern US states in 2018. We conducted spatial distance- and generalized propensity score-matched analysis that adjusts for sociodemographic factors, health behavioral factors, and unmeasured spatial confounding. PPR was measured as inverse-distance weighted averages of petroleum production within 2.5 km or 5 km from refineries, which was strongly correlated with measured levels of sulfur dioxide, a byproduct of PPR. The prevalence of self-reported stroke ranged from 0.4% to 12.7% for all the census tracts of the seven states. People with low socioeconomic status and of Hispanic ethnicity resided closer to petroleum refineries. The non-Hispanic Black population was exposed to higher PPR, while the non-Hispanic White population was exposed to lower PPR. Residential PPR exposure was significantly associated with stroke prevalence. One standard deviation increase in PPR within 5 km from refineries was associated with 0.22 (95% confidence interval: 0.09, 0.34) percentage point increase in stroke prevalence. PPR explained 5.6% (2.4, 8.9) of stroke prevalence in the exposed areas. These values differed by states: 1.1% (0.5, 1.7) in Alabama to 11.7% (4.9, 18.6) in Mississippi, and by census tract-level: 0.08% (0.03, 0.13) to 25.3% (10.6, 40.0). PPR is associated with self-reported stroke prevalence, suggesting possible links between pollutants emitted from refineries and stroke. The increased prevalence due to PPR may differ by sociodemographic factors.

Abstract WP224: Trends In Self-reported Stroke And Myocardial Infarction Prevalence And Associated Modifiable Risk Factors Within Race/ethnicity Strata In The United States From 2011-2019

Background: Stroke and myocardial infarction (MI) prevalence varies by race/ethnicity, as do the risk factors. Methods: We included biyearly data from the 2011-2019 Behavioral Risk Factor Surveillance System (BRFSS) surveys of adults (age ≥18) in the United States. We describe survey-weighted prevalence of self-reported stroke and MI by race and ethnicity. We also describe the prevalence of modifiable vascular risk factors in patients with stroke and MI. Results: The weighted number of U.S. participants represented in BRFSS surveys increased from 237,404,549 in 2011 to 251,703,709 in 2019. Stroke prevalence increased from 2.9% in 2011 to 3.4% in 2019 (&lt;0.001), while MI prevalence did not change over time (4.3% in 2011; 4.2% in 2019). The prevalence of stroke and MI was highest in American Indian/Alaskan Natives (AI/AN) at 5.6% and 7.5% in 2011 and 2019, respectively, compared to 3.2% and 4.8% for whites (p&lt;0.001). Prevalence trends by race/ethnicity are in Figure 1. Modifiable risk factors are in Tables 1&amp;2, which show that AI/AN consistently have the highest or second highest proportion with ≥4 risk factors. Conclusion: Prevalence of self-reported stroke, but not MI, is increasing in the United States. AI/AN consistently had the highest prevalence from 2011-2019 and the highest overall burden of modifiable vascular risk factors, rendering this group more vulnerable to a recurrent vascular event.

Prevalence and Associated Factors of Stroke among Older Adults in India: Analysis of the Longitudinal Aging Study in India-Wave 1, 2017-2018.

Stroke is one of the leading causes of death and disability in India. Stroke survivors may suffer from lifelong physical and cognitive frailty. There is a need for more studies on the prevalence and determinants of this debilitating disease at the national level. Thus, assessing the factors associated with stroke is vital to developing appropriate preventive strategies in India. Data from the Longitudinal Aging Study in India wave 1 (2017-2018) are utilized for this analysis. The survey collected demographics, social, economic, and health data, including lifestyle factors and stroke, from 65,900 older adults ≥45 years representing all states and union territories. Stroke prevalence was calculated for each independent variable, and the differences were compared using the χ2 test. An unconditional multivariable logistic regression model was used to obtain the adjusted odds ratios (AOR) and 95% confidence intervals (CIs) of each lifestyle and socioeconomic variable for stroke prevalence. The prevalence of self-reported stroke was 1.71% (95% CI: 1.61-1.80). Older adults with hypertension (AOR=3.69, 95% CI: 2.95-4.62), family history of stroke (AOR=3.09; 95% CI: 2.33-4.12), arrhythmias (AOR=2.27; 95% CI: 1.20-4.29), physical inactivity (AOR=1.91; 95% CI: 1.55-2.34) were strong contributors of stroke. Diabetes and high cholesterol individuals have 1.5 times more odds for stroke than those without those conditions. Increasing age (AOR=1.57 for 55-69 older adults, and AOR 2.05 for ≥70 years), male sex (AOR=1.75; 95% CI 1.36-2.26), and rich (AOR=1.58; 95% CI: 1.21-2.06) were also associated with increased odds for stroke. The prevalence of stroke was high among adults aged ≥45 years in India. Hypertension, family history of stroke, arrhythmias, and low physical activity were significant contributors to stroke. The findings suggest that preventing and controlling these lifestyle conditions and behaviors may help prevent stroke.

Sleep Duration and Physical Activity Profiles Associated With Self-Reported Stroke in the United States: Application of Bayesian Belief Network Modeling Techniques.

Introduction: Physical activity (PA) and sleep are associated with cerebrovascular disease and events like stroke. Though the interrelationships between PA, sleep, and other stroke risk factors have been studied, we are unclear about the associations of different types, frequency and duration of PA, sleep behavioral patterns (short, average and long sleep durations), within the context of stroke-related clinical, behavioral, and socio-demographic risk factors. The current study utilized Bayesian Belief Network analysis (BBN), a type of machine learning analysis, to develop profiles of physical activity (duration, intensity, and frequency) and sleep duration associated with or no history of stroke, given the influence of multiple stroke predictors and correlates. Such a model allowed us to develop a predictive classification model of stroke which can be used in post-stroke risk stratification and developing targeted stroke rehabilitation care based on an individual's profile.Method: Analysis was based on the 2004–2013 National Health Interview Survey (n = 288,888). Bayesian BBN was used to model the omnidirectional relationships of sleep duration and physical activity to history of stroke. Demographic, behavioral, health/medical, and psychosocial factors were considered as well as sleep duration [defined as short < 7 h. and long ≥ 9 h, referenced to healthy sleep (7–8 h)], and intensity (moderate and vigorous) and frequency (times/week) of physical activity.Results: Of the sample, 48.1% were ≤ 45 years; 55.7% female; 77.4% were White; 15.9%, Black/African American; and 45.3% reported an annual income < $35 K. Overall, the model had a precision index of 95.84%. We found that adults who reported 31–60 min of vigorous physical activity six times for the week and average sleep duration (7–8 h) had the lowest stroke prevalence. Of the 36 sleep (short, average, and long sleep) and physical activity profiles we tested, 30 profiles had a self-reported stroke prevalence lower than the US national average of approximately 3.07%. Women, compared to men with the same sleep and physical activity profile, appeared to have higher self-reported stroke prevalence. We also report age differences across three groups 18–45, 46–65, and 66+.Conclusion: Our findings indicate that several profiles of sleep duration and physical activity are associated with low prevalence of self-reported stroke and that there may be sex differences. Overall, our findings indicate that more than 10 min of moderate or vigorous physical activity, about 5–6 times per week and 7–8 h of sleep is associated with lower self-reported stroke prevalence. Results from the current study could lead to more tailored and personalized behavioral secondary stroke prevention strategies.

The Prevalence of Self-Reported Stroke in the Australian National Eye Health Survey

The study aimed to determine the prevalence of and risk factors for self-reported stroke in Indigenous and non-Indigenous Australians. In this national eye study, 1738 Indigenous Australians (41.1% male) aged 40-92 years and 3098 non-Indigenous Australians (46.4% male) aged 50-98 years from 30 randomly selected sites, stratified by remoteness, were recruited and examined. Sociodemographic information and a history of stroke, diabetes, and ocular health were obtained using an interviewer-administered questionnaire. The crude prevalence of self-reported stroke was 5.04% (156 of 3098, 95% confidence interval: 4.29%-5.87%) for non-Indigenous Australians and 8.75% (152 of 1738, 95% confidence interval: 7.46%-10.17%) for Indigenous Australians (P < .0001). The age-adjusted prevalence of self-reported stroke for non-Indigenous and Indigenous Australians was 4.23% and 12.72%, respectively. The prevalence of stroke increased significantly with age for both Indigenous (odds ratio = 1.06 per year, P ≤ .001) and non-Indigenous Australians (odds ratio = 1.04 per year, P ≤ .001), with the Indigenous prevalence being higher than that of the non-Indigenous group at every age. The prevalence of self-reported stroke was 3 times higher in Indigenous Australians than in non-Indigenous Australians. This disparity is consistent with previous reports, highlighting the need for intensified prevention and support services to reduce the burden of stroke on Indigenous Australians.

Prevalence of self-reported stroke and disability in the French adult population: A transversal study

In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named “the Disability Health Survey” was carried out in people's homes (DHH) and in institutions (DHI). Medical history and functional level (activities-of-daily-living [ADL] and instrumented-activities-of-daily-living [IADL]) were collected through interviews. The modified Rankin Score (mRS) and the level of dependence and disability were compared between participants with and without stroke. Thirty-three thousand eight hundred and ninety-six subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%-1.7%]). The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions) versus respectively 3.9, 3.1 and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke). Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25) than over 85 years (1.5 to 2.2), depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.

Prevalence of self-reported stroke and disability in the French adult population: a transversal study.

In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named “the Disability Health survey” was carried out in people's homes (DHH) and in institutions (DHI). Medical history and functional level (activities-of-daily-living, ADL and instrumented-activities-of-daily-living IADL) were collected through interviews. The modified Rankin score (mRS) and the level of dependence and disability were compared between participants with and without stroke. 33896 subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%–1.7%]). The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions) versus respectively 3.9%, 3.1% and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke). Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25) than over 85 years (1.5 to 2.2), depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.

Prevalence of stroke and related burden among older people living in Latin America, India and China

ObjectivesDespite the growing importance of stroke in developing countries, little is known of stroke burden in survivors. The authors investigated the prevalence of self-reported stroke, stroke-related disability, dependence and care-giver...

Gene polymorphisms in association with self-reported stroke in US adults

Epidemiologic studies suggest that several gene variants increase the risk of stroke, and population-based studies help provide further evidence. We identified polymorphisms associated with the prevalence of self-reported stroke in US populations using a representative sample. Our sample comprised US adults in the Third National Health and Nutrition Examination (NHANES III) DNA bank. We examined nine candidate gene variants within ACE, F2, F5, ITGA2, MTHFR, and NOS3 for associations with self-reported stroke. We used multivariate regression and Cox proportional hazards models to test the association between these variants and history of stroke. In regression models, the rs4646994 variant of ACE (I/I and I/D genotypes) was associated with higher prevalence adjusted prevalence odds ratio [APOR] = 2.66 [1.28, 5.55] and 2.23 [1.30, 3.85], respectively) compared with the D/D genotype. The heterozygous genotype of MTHFR rs1801131 (A/C) was associated with lower prevalence of stroke (APOR = 0.48 [0.25, 0.92]) compared with A/A and C/C genotypes. For rs2070744 of NOS3, both the C/T genotype (APOR = 1.91 [1.12, 3.27]) and C/C genotype (APOR = 3.31 [1.66, 6.60]) were associated with higher prevalence of stroke compared with the T/T genotype. Our findings suggest an association between the prevalence of self-reported stroke and polymorphisms in ACE, MTHFR, and NOS3 in a population-based sample.

Prevalence and risk factors for cerebrovascular disease in community-dwelling Latinos

Objectives Surveys on stroke prevalence may provide valuable information for planning of healthcare services. Few such studies have been conducted in Latinos and none have been performed in Los Angeles, a County that contains the largest population of Latinos in the United States. We sought to assess the prevalence of self-reported stroke in a population-based sample of community-dwelling Latinos in Los Angeles. Patients and methods The group comprised of self-identified Latinos aged 40 years and older from six census tracts in Los Angeles participating in a population-based cross-sectional study of ocular disease in Latinos, The Los Angeles Latino Eye Study (LALES). The prevalence of stroke and its association with demographic, biological and behavioral risk factors was determined. Univariate and multiple stepwise logistic regression models were used to calculate odds ratios (ORs). Results The prevalence of self-reported stroke in 6954 community-dwelling Latinos in Los Angeles was 3.3%. Stroke prevalence increased with age (1.4% age 40–50, 3.3% age 50–65, 7.1% age >65), history of hypertension (OR 2.6, p < 0.001), heart disease (OR 4.8, p < 0.001) and diabetic retinopathy (OR 2.1, p = 0.01). Conclusions Renewed efforts directed at early identification and treatment of hypertension and heart disease within the Latino community will mitigate the burden of stroke.

Serum albumin and self-reported prevalence of stroke: a population-based, cross-sectional study

Since information about the association between serum albumin and risk of stroke is limited the purpose of the present paper was to re-investigate this relationship. The study followed a cross-sectional design. In the cross-sectional Norwegian Oslo Health Study the concentration of serum albumin and blood pressure was determined in a random sample of 5071 men and women, 30-75 years of age. Logistic regression was used to study the association between the serum albumin concentration and self-reported prevalence of stroke. In the sample there were 122 subjects with a history of stroke and 4949 subjects without. Low albumin (i.e. ≥ 47 versus >47 g/l) was associated with increased prevalence of self-reported stroke (odds ratio 1.83; 95% confidence interval, 1.20-2.78; P=0.005), after adjusting for age (≥ 45 versus ≥ 59 years) and sex. Including smoking, blood pressure and length of education into the model did not have any major influence on the result. Conclusion Low serum albumin is associated with increased prevalence of self-reported stroke.

Serum albumin and self-reported prevalence of stroke: a population-based, cross-sectional study

Since information about the association between serum albumin and risk of stroke is limited the purpose of the present paper was to re-investigate this relationship. The study followed a cross-sectional design. In the cross-sectional Norwegian Oslo Health Study the concentration of serum albumin and blood pressure was determined in a random sample of 5071 men and women, 30-75 years of age. Logistic regression was used to study the association between the serum albumin concentration and self-reported prevalence of stroke. In the sample there were 122 subjects with a history of stroke and 4949 subjects without. Low albumin (i.e. < or =47 versus >47 g/l) was associated with increased prevalence of self-reported stroke (odds ratio 1.83; 95% confidence interval, 1.20-2.78; P=0.005), after adjusting for age (< or =45 versus > or =59 years) and sex. Including smoking, blood pressure and length of education into the model did not have any major influence on the result. Low serum albumin is associated with increased prevalence of self-reported stroke.