Prevalence Rates Of Stroke Research Articles

Fluoride Exposure from Drinking Water Increases the Risk of Stroke: An Ecological Study in Changwu Town, China.

Stroke is a major cause of death globally and the leading cause in China. Excessive fluoride exposure has been linked to cardiovascular conditions related to stroke risk factors such as hypertension, atherosclerosis, dyslipidemia, and cardiomyopathy. However, evidence supporting the association between fluoride exposure and stroke risk is limited. We constructed an ecological study in Changwu Town, Heilongjiang Province, China, a typical endemic fluorosis area caused by excessive fluoride exposure from drinking water. We collected demographic data, stroke prevalence, and mortality information from 2017 to 2021. Fluoride exposure data were obtained from the national monitoring project on endemic fluorosis. Water fluoride concentrations were measured using the standardized methods. Trend changes in stroke rates were assessed using annual percentage change (APC). Differences in stroke rates among fluoride exposure groups were analyzed using chi-square tests. From 2017 to 2021, the all-ages and age-standardized stroke prevalence rates of permanent residents in Changwu Town increased year by year, while the all-ages and age-standardized mortality rates did not change significantly. The prevalence rates of stroke were significantly higher in endemic fluorosis areas compared to non-endemic areas (p < 0.001). Stratifying the population into tertile groups based on the water fluoride cumulative exposure index (WFCEI) revealed statistically significant differences in stroke prevalence rates (p < 0.001), showing a dose-response relationship with the WFCEI. However, the all-ages and age-standardized mortality rates of stroke were not found to be related to fluoride exposure. Long-term excessive fluoride exposure from drinking water may increase the risk of stroke prevalence, indicating fluoride overexposure as a potential risk factor for stroke.

Ethnic and region-specific genetic risk variants of stroke and its comorbid conditions can define the variations in the burden of stroke and its phenotypic traits.

Burden of stroke differs by region, which could be attributed to differences in comorbid conditions and ethnicity. Genomewide variation acts as a proxy marker for ethnicity, and comorbid conditions. We present an integrated approach to understand this variation by considering prevalence and mortality rates of stroke and its comorbid risk for 204 countries from 2009 to 2019, and Genome-wide association studies (GWAS) risk variant for all these conditions. Global and regional trend analysis of rates using linear regression, correlation, and proportion analysis, signifies ethnogeographic differences. Interestingly, the comorbid conditions that act as risk drivers for stroke differed by regions, with more of metabolic risk in America and Europe, in contrast to high systolic blood pressure in Asian and African regions. GWAS risk loci of stroke and its comorbid conditions indicate distinct population stratification for each of these conditions, signifying for population-specific risk. Unique and shared genetic risk variants for stroke, and its comorbid and followed up with ethnic-specific variation can help in determining regional risk drivers for stroke. Unique ethnic-specific risk variants and their distinct patterns of linkage disequilibrium further uncover the drivers for phenotypic variation. Therefore, identifying population- and comorbidity-specific risk variants might help in defining the threshold for risk, and aid in developing population-specific prevention strategies for stroke.

Prevalence and Risk Factors of Stroke in Inpatients with Type 2 Diabetes Mellitus in China.

The prevalence and the cluster characteristics of risk factors of stroke were assessed in a Chinese diabetic population. Clinical data of 30 693 inpatients who were diagnosed with type 2 diabetes mellitus (T2DM) and admitted between 2013 and 2018 were retrospectively analyzed. The age-standardized prevalence of stroke was estimated using the 2010 Chinese population census data, and risk factors were analyzed by multiple imputation and regression. The crude and standardized prevalence rates of stroke in patients with T2DM were 34.4% and 21.5%, respectively, and 85.2% of the stroke patients had ischemic stroke. Nearly half of the patients who experienced stroke had clusters of more than 4 risk factors. Compared with no-risk-factor clustering, the risk of stroke significantly increased 3-4 times in the presence of more than 4 risk-factor clusters (P<0.001). Hypertension was the most common major risk factor for ischemic stroke [odds ratio (OR), 2.34; 95% confidence interval (CI), 2.18-2.50] and hemorrhagic stroke (OR, 3.68; 95% CI 2.95-4.59; P<0.001). Moreover, a 1-standard-deviation increase in fasting blood glucose (FBG) was significantly negatively correlated with ischemic stroke risk, and the same change in FBG was significantly associated with an 8% increased risk of hemorrhagic stroke. The prevalence of stroke in patients with T2DM is rather high, and the clustering of risk factors is associated with the development of stroke in T2DM patients. Risk factors differ in different stroke subtypes. Identifying risk factors for a specific high-risk group is necessary.

Global burden of stroke in adolescents and young adults (aged 15–39 years) from 1990 to 2019: a comprehensive trend analysis based on the global burden of disease study 2019

SummaryIntroductionThe incidence of stroke is rising among individuals aged 15–39. Insufficient research targeting this age group hampers the development of effective strategies. This study analyzes data from the Global Burden of Disease Study 2019 (GBD 2019) to examine trends from 1990 to 2019 and propose future interventions.MethodsData on ischemic strokes, intracerebral hemorrhage, and subarachnoid hemorrhage from 1990 to 2019 was collected from the Global Health Data Exchange (GHDx) platform. We used the Annual Average Percentage Change (AAPC) to assess global trends in incidence, prevalence, Disability-Adjusted Life Years (DALYs), and mortality rates across various stroke categories. Joinpoint models identified significant years of trend inflection. Trend analyses were segmented by age, gender, and Sociodemographic Index (SDI).FindingsFrom 1990 to 2019, the global incidence of ischemic stroke within the adolescents and young adults (AYAs) cohort declined from 1990 to 1999, further decreased from 2000 to 2009, and then increased from 2010 to 2019. The overall AAPC p-value showed no significant difference. Mortality rates for ischemic strokes were consistently reduced during this period. The overall incidence rate of intracerebral hemorrhage has exhibited a downward trend. Meanwhile, the incidence rate of subarachnoid hemorrhage decreased from 1990 to 2009, yet saw a resurgence from 2010 to 2019. Male ischemic stroke incidence grew more than female incidence, but both absolute incidence and rates were higher for females. Differences in SDI levels were observed, with the fastest increase in incidence occurring in low-middle SDI regions, followed by high SDI regions, and the smallest increase in low SDI regions. Conversely, the most rapid decline was noted in high-middle SDI regions, with no significant change observed in middle SDI regions.ConclusionA concerning trend of increasing ischemic stroke incidence, DALYs, and prevalence rates has emerged in the global 15–39 age group, especially among those aged 30–39. This increase is evident across regions with varying SDI classifications. To combat this alarming trend among adolescents and young adults, enhancing preventive efforts, promoting healthier lifestyles, strengthening the healthcare system’s responsiveness, and maintaining vigilant epidemiological monitoring is essential.

Global, regional, and national burden of stroke from 1990 to 2019: A temporal trend analysis based on the Global Burden of Disease Study 2019.

Stroke is the second leading cause of death and the leading cause of disability worldwide. However, how the prevalence of stroke varies across the world is uncertain. The aim of this study was to analyze temporal trends of prevalence for stroke, including ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) at the global, regional, and national levels. The age-standardized prevalence rates (ASPR) of stroke, IS, ICH, and SAH, along with their corresponding 95% uncertainty intervals (UI), were derived from data in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This provides estimates for the burden of 369 diseases and injuries globally in 2019, as well as their temporal trends over the past 30 years. Joinpoint regression analysis was used to analyze the 1990-2019 temporal trends by calculating the annual percentage change (APC) and average annual percentage change (AAPC), as well as their 95% confidence interval (CI). In 2019, the global ASPR of stroke was 1240.263 per 100,000 population (95% UI: 1139.711 to 1352.987), with ASPRs generally lower in Europe compared to other regions. Over the period from 1990 to 2019, a significant global decrease in ASPR was observed for stroke (AAPC -0.200, 95% CI: -0.215 to -0.183), IS (AAPC -0.059%, 95% CI: -0.077 to -0.043), SAH (AAPC -0.476, 95% CI: -0.483 to -0.469), and ICH (AAPC -0.626, 95% CI: -0.642 to -0.611). The trends of ASPR of stroke, IS, SAH, and ICH varied significantly across 204 countries and territories. Our findings highlight significant global disparities in stroke prevalence, emphasizing the need for ongoing monitoring and intensified efforts in developing regions to reduce the global burden of stroke.

Expert opinion on stroke management: An Indian observational study

: Stroke is the leading cause of long-term disability and one of the top causes of mortality worldwide. The burden in India has been increasing at an alarming rate over the past few decades. India with its culturally diverse environment and economically developing status presents unique challenges in stroke management. This study is an initiative designed to gain a better understanding of stroke prevalence and therapy in India. : A cross-sectional questionnaire-based study among Indian Cardiologists was conducted. A convenient sampling method was used. About 34% of doctors said that acute stroke is most prevalent in the age group of 41- 50 years in their clinical setup. The study results also highlight that piracetam 800mg is the preferred effective option for age-related cognitive disorders. Some of them preferred Piracetam for vertigo of mixed origin, vestibular, and other associated disorders of vertiginous attacks. 51% of doctors observed that vertigo is diagnosed more frequently among both genders, more common in the age group of 21-30 years. 93% of doctors agreed that piracetam improves cognitive improvement post-surgery. Three-fourths of doctors who participated in the survey rated 45% of doctors prescribed the combination of piracetam and citicoline in post-stroke recovery patients. Also, 40% of them prescribed neuroprotective agents to 51-70% of stroke patients. This study demonstrated that the stroke prevalence rate is high among patients above 40 years of age. Piracetam 800 mg is commonly prescribed to most of the stroke patients. Half of the respondents felt that there was a significant improvement in cognitive decline with piracetam. This study's findings highlight that piracetam is an effective option for age-related cognitive disorders.

Abstract TP122: Variables Associated With Post-Stroke PTSD; a Systematic Review and Narrative Synthesis

Background: Stroke is often a sudden, traumatic, and potentially catastrophic event for those who experience it, leading to many stroke survivors experiencing post-stroke post-traumatic stress disorder (sPTSD). The development of sPTSD may impede patients' rehabilitation and negatively affect their long-term physical and psychological outcomes. Aim: This review aims to identify and provide a narrative synthesis of the factors associated with sPTSD onset. Methods: Six databases (Web of Science, social sciences citation index, Embase, Pubmed, PsychInfo, Cinahl and PTSDPubs) were searched for studies that included samples of people who were 18 years of age or over, had had a stroke that was clinically recorded and who had a clinical diagnosis of PTSD post-stroke. Results: A total of 21 studies were included in the review, with prevalence rates of stroke varying between 6.5% - 31%, and the PDS and PCL being the most frequent method of assessing PTSD. The most common factors found to be associated with the onset of PTSD were depression, younger age, symptoms of anxiety and lifetime history of psychiatric comorbidity. Conclusion: Following a stroke, patients are at an increased risk for developing sPTSD. Preliminary analyses would suggest certain factors such as gender, age, and marital status impact the development of sPTSD. However, an agreed-upon, standardised practice in measuring and reporting SPTSD is necessary to ensure findings can be readily contextualised against previous research in a sensible and meaningful way.

Global prevalence of cardiovascular diseases by gender and age during 2010-2019.

The aim of this study was to evaluate the global, gender, and age-related cardiovascular disease (CVD) burden during 2010-2019. Not only the global trend in the prevalence of CVDs was studied but also whether there was a statistically significant difference between genders and ages during 2010-2019. Detailed information from 2010 to 2019, including global rates of prevalence of 11 categories of CVD, was collected from the Global Burden of Disease Study 2019. The statistical methods used to analyze the results of this study are the independent samples t-test and one-way analysis of variance (ANOVA) test. The global prevalence rate of CVDs increased from 0.061% in 2010 to 0.070% in 2019. There was a statistically significant difference in prevalence rates between genders in all cardiovascular diseases except atrial fibrillation and flutter. Females have higher prevalence rates of CVDs worldwide. Moreover, females have statistically significantly higher prevalence rates of stroke, hypertensive heart disease, rheumatic heart disease, non-rheumatic valvular heart disease, endocarditis, peripheral artery disease and other cardiovascular and circulatory diseases globally. On the other hand, males have statistically significantly higher prevalence rates of cardiomyopathy and myocarditis, and ischemic heart disease globally. Rheumatic heart disease has a statistically significantly higher prevalence rate in the age group of 25-49 years than the other age groups. The significance of this study is not only that it has succeeded in evaluating the global, gender, and age-related cardiovascular disease (CVD) burden, finding statistically significant associations, but it is also the only study to achieve this goal in the last decade.

Study of Cerebral Hemispheric Lateralization in Stroke and the Arterial Territories Involved in High-risk Patients

Introduction: According to WHO, Stroke is the 2nd leading cause of death and disability after Ischemic heart disease. Prevalence rate of stroke in India varies from 44.45 to 150 per lakh population. Studies have reported a higher frequency of stroke of the left hemisphere. The artery reported to be the most affected is Left Middle Cerebral artery(MCA) followed by Right Middle Cerebral artery. The aim of this study is to determine the side of cerebral hemisphere most affected by stroke and the arterial territories involved in high-risk patients aged above 35 years presenting to the tertiary healthcare centre, as well as to study the sex predilection of stroke. Materials and Methods: A cross-sectional prospective study of 50 high risk stroke patients with Diabetes Mellitus(DM) and /or Hypertension(HTN) presenting to General medicine OPD of a tertiary healthcare centre were investigated with CT/MRI for the side of the cerebral hemisphere affected and the arterial territories involved. The data was tabulated over the course of three months and statistical analysis was carried out. Results: The left cerebral hemisphere was affected in 50%, right in 40% and bilateral involvement was found in 10% patients. Slight predilection of stroke towards the left was seen, however it was not found to be statistically significant (P-value= 0.249). MCA territory was involved in 66% of the patients, Posterior Cerebral Artery(PCA) territory in 8%, Vertebrobasilar Artery(VB) territory in 8%, Anterior Cerebral Artery(ACA) territory in 6% and MCA+ACA in 4%, MCA+VB in 2% and MCA-PCA watershed in 6% patients. Conclusions: We found a slight predilection of stroke towards the left, which was however, not found to be statistically significant. We also found that Middle Cerebral Artery(MCA) territory is the most commonly involved in stroke.

Rehabilitation of post-stroke aphasia in Ghana.

Aphasia, a common consequence of stroke, which affects both communication and social functioning, and in turn, quality of life, is on the rise due to increases in stroke prevalence and survival rate. The rehabilitation of post-stroke aphasia primarily falls within the purview of speech-language pathology and research supports the effectiveness of such services. However, provision of aphasia rehabilitation services in sub-Saharan Africa is associated with challenges. This study aimed to examine rehabilitation services for individuals with post-stroke aphasia in Ghana by exploring the roles of the stakeholder groups involved in the assessment and treatment of post-stroke aphasia in Ghana, as well as the challenges they encounter in providing or identifying services. The stakeholder groups included educational institutions, interdisciplinary healthcare professionals, and family caregivers of individuals with post-stroke aphasia. A qualitative case study approach was used to collect and integrate from multiple sources data such as demographic information, interview responses and program syllabi to develop a holistic image. Fifteen respondents from the stroke and speech therapy units at Komfo Anokye and Korle-Bu Teaching Hospitals, University of Ghana, and University of Health and Allied Sciences, Ghana were purposively sampled. Interview questions were developed and centred on aphasia education and training, knowledge of speech-language pathology services, speech-language pathology service delivery, access to speech-language pathology services, challenges in both delivery and access to speech-language pathology services and suggestions for improving speech-language pathology services. In-person and virtual interviews were conducted after demographic information was collected. Interviews were analysed thematically, and demographic information and program syllabi were triangulated with the interview data collected. All stakeholder groups identified concerns with current aphasia services in Ghana. Issues raised included the insufficient number of speech-language pathologists, lack of awareness of speech-language pathology services for post-stroke aphasia (among healthcare professionals and the public), absence of aphasia management information and clinical training in educational programming, lack of interest in speech-language pathology training programs, financial challenges, spiritual and traditional beliefs and geographic barriers (i.e., speech-language pathology services are currently available in only a few cities). These findings emphasised the need to improve post-stroke aphasia rehabilitation in Ghana. The process of data collection itself educated respondents on the importance of post-stroke aphasia rehabilitation, and by identifying barriers, strategies to improving services, such as designing standardised aphasia assessments for the Ghanaian context, can now be initiated. What is already known on the subject To address post-stroke aphasia, evidence-based speech-language pathology services are provided. However, there is a paucity of studies on post-stroke aphasia services in Ghana, preventing an accurate report of services and practices in the country. What this study adds This study provides an overview of the existing rehabilitation services for post-stroke aphasia in Ghana. It highlights challenges facing the existing services and suggested strategies to improve post-stroke aphasia services. What are the clinical implications of this work? The study created awareness among healthcare professionals and general public (study participants) about the importance of rehabilitation services for post-stroke aphasia. Based on the study findings, appropriate stakeholders such as policy makers, researchers, and healthcare professionals can further design assessments and interventions to improve rehabilitation, including speech-language pathology services, for post-stroke aphasia in Ghana.

Poor treatment outcomes and associated factors among hospitalized patients with stroke at Hiwot Fana Comprehensive Specialized Hospital, eastern Ethiopia

BackgroundStroke is a significant health problem in both industrialized and developing nations. It is the world's second-leading cause of death worldwide. Stroke incidence, prevalence, and death rates have grown internationally, with low- and middle-income nations suffering the greatest proportion of the burden. Stroke is a leading cause of long-term physical impairment, affecting a person's quality of life, societal engagement, independence, emotions, and productivity.ObjectiveTo determine the magnitude and factors associated with poor treatment outcomes in hospitalized adult patients with stroke.MethodsA hospital-based cross-sectional study was conducted from January 2019 to June 2021 in stroke patients admitted to the Hiwot Fana Comprehensive Specialized Hospital. This study included 290 patient charts. Data were collected by reviewing the medical charts using a well-developed data abstraction form. Data were entered into Epi-Data version 3.2 and exported to SPSS version 25.0. Descriptive statistics were used to describe study variables. Additionally, bivariable and multivariable logistic regression analyses were used to identify factors associated with poor stroke treatment outcomes. All statistical tests were set at 5% of significant threshold.ResultsAmong 290 enrolled patients, 172 (59.3%) had poor stroke treatment outcomes. The mean age of the patients was 54.7(SD: ±16.1) years, and more than half 182 (62.8%) of the participants were males. The overall average length of hospital stays for stroke patients was 8 ± 3.3 days. Age of 45–64 years (adjusted odds ratio [AOR]: 2.17, 95% CI [1.06, 4.41]), aspiration pneumonia (AOR: 2.13, 95% CI [1.06, 4.26]), systolic blood pressure ≥ 140 mm Hg/dl (AOR: 2.35, 95% CI [1.24, 4.47]), Glasgow Coma Scale score of &amp;lt;8 (AOR: 7.26, 95% CI [3.82, 13.8]), and serum creatinine level of ≥1 mg/dl (AOR: 2.73, 95% CI [1.46, 5.10]) were significantly associated with poor treatment outcome in adult stroke patients.ConclusionSix out of ten stroke patients had poor treatment outcomes. Age between 45 and 65 years, uncontrolled hypertension, aspiration pneumonia, low Glasgow Coma Scale score at admission, and renal injury were identified as significantly associated with poor treatment outcomes in stroke patients.

Predictive Effect of System Inflammation Response Index for Progression of Chronic Kidney Disease in Non-Dialyzing Patient.

Scant research has been conducted on the interplay between the systemic inflammation response index (SIRI) and chronic kidney disease (CKD). The present study endeavors to meticulously scrutinize the association between SIRI and renal function. Additionally, we aim to assess its efficacy in predicting the progression of CKD in non-dialysis patients. Adult patients with CKD who were not undergoing dialysis were enrolled, and follow-up data were obtained. Data from distinct groups were extracted and meticulously compared. A comprehensive analytical approach was adopted, including logistic regression analysis, Kaplan-Meier analysis, Cox proportional hazards regression analysis, and subgroup analysis. Our study included 1420 patients, with a mean age of 61 ± 17 years, and 63% were male. 244 (17.2%) patients experienced the progression of CKD. As the level of ln(SIRI) increased, patients tended to be older, with a higher proportion of males, and increased prevalence rates of hypertension, stroke, heart failure, and progression of CKD. Additionally, the levels of baseline creatinine and C-reactive protein were elevated, while the levels of estimated glomerular filtration rate and hemoglobin decreased. Upon adjusting for demographic and biochemical variables, logistic regression analysis indicated that ln(SIRI) was independently associated with advanced CKD in pre-dialysis patients (OR=1.59, 95% CI: 1.29-1.95, P<0.001). Moreover, Cox proportional-hazard analysis revealed that ln(SIRI) independently predicted CKD progression (HR: 1.3, 95% CI: 1.07-1.59, P=0.009). Conducting a subgroup analysis, we observed significant interactions between ln(SIRI) levels and gender (p<0.001), age (p=0.046), and hypertension (p=0.028) in relation to the progression of CKD. Our study's findings demonstrate a significant association between SIRI and fundamental renal function, and independently establish a correlation between SIRI and the progression of CKD in pre-dialysis patients. These observations suggest that SIRI holds promise as a potential predictor for CKD progression.

Ethnic disparities in prevalence of chronic non-communicable diseases and its multimorbidity among older adults in rural southwest China

BackgroundAs the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest Chinese older adults.MethodsA cross-sectional survey was conducted in rural southwest population aged ≥ 60 years consisting of 5,642 consenting participants of Han and three ethnic minority groups (Dai, Ha Ni, and Bai). Information about participants’ demographic characteristics and lifestyle behaviors was obtained using a standard questionnaire. Anthropometric measurements including height, weight, and waist circumference, fasting blood sugar and blood pressure measurement, as well as post-bronchodilator spirometry test were recorded for each participant.ResultsThe age-standardized prevalence of five common chronic NCDs– hypertension, diabetes, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD) – and its multimorbidity was 72.8%, 15.9%, 4.0%, 10.0%, 9.8%, and 27.6%, respectively. Bai participants had both the highest overall and sex-specific prevalence rates of hypertension, diabetes, stroke, and COPD, whereas Han participants had the highest rates of CHD (P < 0.01). The results of multivariate logistic regression analysis indicated that female and older participants had a higher probability of chronic NCDs multimorbidity than their counterparts (P < 0.01). Bai ethnic minority participants were more likely to have NCDs multimorbidity while Ha Ni and Dai ethnic minority participants were less likely to have NCD multimorbidity relative to the Han participants (P < 0.05). Older adults with a higher level of education and family history of chronic NCDs, and who were also current smokers, current drinkers, obese, centrally obese, and physically inactive had a greater probability of developing chronic NCDs multimorbidity (P < 0.01).ConclusionsEthnicity and individual demographic and lifestyle factors significantly impact prevalence of chronic NCDs multimorbidity. Future chronic NCDs prevention and control strategies must be tailored to address ethnicity, and culturally tailored lifestyle interventions may reduce the prevalence of chronic NCDs multimorbidity in rural southwest China.

Impacts of exposure to ambient temperature and altitude on the burden of stroke.

To evaluate the impact of ambient temperature and altitude exposure on the burden of stroke in a Chinese cohort. This study was conducted using data from the National Stroke High-Risk Population Screening System 2020, which assess the overall prevalence, incidence, and mortality rate of stroke in China. For this study, we obtained the annual mean ambient temperature, diurnal temperature range, and altitude for each city. Body mass index (BMI) of participants were calculated. The sample comprised 676,394 adults aged 40years or older from 170 cities in 31 provinces in China. A negative linear relationship between mean ambient temperature and stroke risk (incidence and prevalence) as well as a negative association between mean ambient temperature and stroke mortality had been found. A nonlinear relationship with decreased risk in both high and low diurnal temperature range is observed for stroke burden (incidence, prevalence, and mortality). There is no significant correlation between city altitude and stroke burden. The U-shaped relationships of BMI with the incidence and prevalence of stroke indicate that the lowest incidence and prevalence are observed when BMI is approximately 20. Overall, our study provides important insights into the environmental and individual factors that contribute to the burden of stroke in China, and may inform public health interventions aimed at reducing this burden.

Estimated Burden of Stroke in China in 2020

Stroke is the leading cause of death in China. However, recent data about the up-to-date stroke burden in China are limited. To investigate the urban-rural disparity of stroke burden in the Chinese adult population, including prevalence, incidence, and mortality rate, and disparities between urban and rural populations. This cross-sectional study was based on a nationally representative survey that included 676 394 participants aged 40 years and older. It was conducted from July 2020 to December 2020 in 31 provinces in mainland China. Primary outcome was self-reported stroke verified by trained neurologists during a face-to-face interviews using a standardized protocol. Stroke incidence were assessed by defining first-ever strokes that occurred during 1 year preceding the survey. Strokes causing death that occurred during the 1 year preceding the survey were considered as death cases. The study included 676 394 Chinese adults (395 122 [58.4%] females; mean [SD] age, 59.7 [11.0] years). In 2020, the weighted prevalence, incidence, and mortality rates of stroke in China were 2.6% (95% CI, 2.6%-2.6%), 505.2 (95% CI, 488.5-522.0) per 100 000 person-years, and 343.4 (95% CI, 329.6-357.2) per 100 000 person-years, respectively. It was estimated that among the Chinese population aged 40 years and older in 2020, there were 3.4 (95% CI, 3.3-3.6) million incident cases of stroke, 17.8 (95% CI, 17.5-18.0) million prevalent cases of stroke, and 2.3 (95% CI, 2.2-2.4) million deaths from stroke. Ischemic stroke constituted 15.5 (95% CI, 15.2-15.6) million (86.8%) of all incident strokes in 2020, while intracerebral hemorrhage constituted 2.1 (95% CI, 2.1-2.1) million (11.9%) and subarachnoid hemorrhage constituted 0.2 (95% CI, 0.2-0.2) million (1.3%). The prevalence of stroke was higher in urban than in rural areas (2.7% [95% CI, 2.6%-2.7%] vs 2.5% [95% CI, 2.5%-2.6%]; P = .02), but the incidence rate (485.5 [95% CI, 462.8-508.3] vs 520.8 [95% CI, 496.3-545.2] per 100 000 person-years; P < .001) and mortality rate (309.9 [95% CI, 291.7-328.1] vs 369.7 [95% CI, 349.1-390.3] per 100 000 person-years; P < .001) were lower in urban areas than in rural areas. In 2020, the leading risk factor for stroke was hypertension (OR, 3.20 [95% CI, 3.09-3.32]). In a large, nationally representative sample of adults aged 40 years or older, the estimated prevalence, incidence, and mortality rate of stroke in China in 2020 were 2.6%, 505.2 per 100 000 person-years, and 343.4 per 100 000 person-years, respectively, indicating the need for an improved stroke prevention strategy in the general Chinese population.

Prehospital stroke care in Africa: The reality and potential solutions.

Prehospital stroke care in Africa: The reality and potential solutions.

Measuring the burden of comorbidity for ischaemic heart disease and four common non-communicable diseases in Iran, 1990–2017: a modelling study based on global burden of diseases data

ObjectiveThis modelling study aimed to estimate the comorbidity burden for four common non-communicable diseases with ischaemic heart diseases (IHD) in Iran during a period of 28 years.DesignAnalysis of the burden...

Comparison study of clinical presentation and risk factors for cerebrovascular stroke in diabetic versus nondiabetic patients

BackgroundDiabetes and stroke prevalence rates are increasing worldwide, and both are major human health threats causing disability and death. Diabetes is a well-known independent risk factor for stroke. In addition, diabetes increases the prevalence of other stroke risk factors; however, few studies evaluate whether diabetes may influence stroke presentation.Aim of the workThis study was conducted to assess the risk factors and clinical presentation of stroke in patients with and without diabetes.Patients and methodsThis cross-sectional study was conducted on 200 patients with radiologically confirmed acute cerebrovascular stroke, selected from tertiary care hospitals in Alexandria, Egypt. They were divided into 2 groups: group 1: 100 patients with diabetes for more than 5 years and group 2: 100 nondiabetic patients. All patients were evaluated for risk factors, stroke types, and clinical presentation.ResultsCompared with nondiabetic patients, diabetic patients with stroke had a significantly higher prevalence of hypertension (p = 0.031) and dyslipidemia (p = 0.016) and higher incidence of ischemic stroke (p = 0.030), and they were more likely to present with motor deficit (p = 0.045) and dysarthria (p = 0.048). There was a modest difference between diabetic and nondiabetic group regarding OCSP ischemic stroke subtypes, but it was non-significant.ConclusionThere was a significant difference in stroke risk factors, pathological types, and presentation between diabetic and nondiabetic patients, but not in ischemic stroke anatomical subtypes.

Correlation of magnetic angiography with relative cerebral blood flow on arterial spin labeling using magnetic resonance imaging in acute ischemic stroke patients

Introduction: Acute ischemic stroke is one of the three main causes of death in developed countries. RISKESDAS data of 2013 depicted the fact that the prevalence rate of stroke was 12.1 per 1,000 population. CT protocol and magnetic resonance imaging (MRI) are excellent evaluations of acute ischemic stroke. Magnetic resonance angiography (MRA) is an MRI technique to delineate arteries and evaluate stenosis and occlusion. Arterial Spin Labeling (ASL) MRI is quantitative and non-invasive, does not require Gadolinium contrast, measures cerebral blood flow, is useful for performing perfusion-based functional MRI (fMRI), and is able to be reevaluated. The study aimed to analyze the correlation between MRA and the relative Cerebral Blood Flow on ASL in patients with acute ischemic stroke. Methods: The study aimed to analyze the correlation between MRA and the relative Cerebral Blood Flow on ASL in patients with acute ischemic stroke. Results: The patients with acute ischemic stroke were in the age category of 40 years or more (92.3%) with the average age of the patients was 56.96 years  14.05. The youngest patient was 8 years old and the oldest one was 79 years old. Most of them were women (56.5%) with the most comorbid hypertension (45.7%) and diabetes mellitus (34.8%). The results of the evaluation after agreeing the consent portrayed that MRA was normal in 10 patients (21.7%) and there was stenosis or occlusion in 36 patients (78.3%). ASL examination showed that 20 patients (43.5%) were normal, whereas 26 patients (56.5%) were decreased. Conclusion: Phi value was 0.601 (p &lt; 0.05), meaning that there was a strong relationship between the results of MRA examination and ASL.

Ischemic Stroke of Brain Management Approach Through Ayurveda - A Single Case Study

Stroke is one among such diseases which needs immediate care and attention as it causes death and disabilities in the person, hence considered as a major burden in developing countries like India. The estimated adjusted prevalence rate of stroke in India ranges from 84-262/1,00,000 in rural and 334-424/1,00,000 in urban areas. The incidence rate is 119-145/1,00,000 based on the recent population-based study. The nearest clinical entity for stroke is Pakshaghata. Methodology: A 51yrs old male patient who is a known case of DM since 6years under regular medication approached to OPD of SKAMCH &amp; RC Bangalore, with a Lakshana of loss of function, sensation, speech etc where mainly right half of the body was affected. Based on the clinical presentation and Ayurvedic parameters, the condition was diagnosed as Pakshaghata with special reference to ischemic stroke with possible multiple lacunar infarcts and Chikitsa was adopted keeping Dhatukshayajanya pathology as base. The treatment such as Sarvanga Abhyanga, Sarvanga Nadi swda, Sarvanga shashtika shali pinda sweda and Basti with oral medications like Suvarna sameerapannaga rasa, Vidaryadi Kashaya, ashtavarga Kashaya, balarishta and Cap. Palsineuron were prescribed. Result: There were drastic improvements seen in the Lakshanas. Overall fruitful result was achieved even follow up were maintained. Discussion: This article is a discussion about a case of ischemic stroke of brain which was successfully treated with Ayurvedic approach. The disease Pakshaghata with its Lakshanas, Nidana, Samprapti, Sampraptivighatana of Chikitsa given, along with the approach to conclude its possible modern co-relation as Ischemic stroke of brain were the main points Sampraptivighatana, chikitsa given, consideration. Conclusion: The above-described sets of Panchakarma treatment along with Shamanoushadhi has shown significant result clinically with speedy recovery within a month in the patient in the present study.