Risk Factors In General Population Research Articles

Common and Unique Risk Factors for Intimate Partner Violence Victimization Among Sexual and Gender Minority Individuals Assigned Female at Birth.

Sexual and gender minority youth assigned female at birth (SGM-AFAB) are at disproportionately high risk for intimate partner violence victimization (IPVV), yet remain understudied. Using two time points of data collected from 367 SGM-AFAB young people (aged 16-31 years), we tested whether common, general population risk factors (childhood violence, depression, alcohol and cannabis use, and low social support) and unique stigma-related factors (enacted stigma, microaggressions, and internalized stigma) prospectively predicted psychological, physical, sexual, and identity abuse IPVV in the following 6 months. Results indicated that some traditional risk factors, including child abuse, depression, cannabis use, and low social support, raise IPVV risk among SGM-AFAB youth. Microaggressions and internalized stigma represent additional, unique IPVV risk factors in this population. SGM-affirmative efforts to prevent IPVV should address these common and SGM-specific risk factors.

COVID-19 Prevention Strategies for Victoria Students within Educational Facilities: An AI-Based Modelling Study

Educational institutions play a significant role in the community spread of SARS-CoV-2 in Victoria. Despite a series of social restrictions and preventive measures in educational institutions implemented by the Victorian Government, confirmed cases among people under 20 years of age accounted for more than a quarter of the total infections in the state. In this study, we investigated the risk factors associated with COVID-19 infection within Victoria educational institutions using an incremental deep learning recurrent neural network-gated recurrent unit (RNN-GRU) model. The RNN-GRU model simulation was built based on three risk dimensions: (1) school-related risk factors, (2) student-related community risk factors, and (3) general population risk factors. Our data analysis showed that COVID-19 infection cases among people aged 10-19 years were higher than those aged 0-9 years in the Victorian region in 2020-2022. Within the three dimensions, a significant association was identified between school-initiated contact tracing (0.6110), vaccination policy for students and teachers (0.6100), testing policy (0.6109), and face covering (0.6071) and prevention of COVID-19 infection in educational settings. Furthermore, the study showed that different risk factors have varying degrees of effectiveness in preventing COVID-19 infection for the 0-9 and 10-19 age groups, such as state travel control (0.2743 vs. 0.3390), international travel control (0.2757 vs. 0.3357) and school closure (0.2738 vs. 0.3323), etc. More preventive support is suggested for the younger generation, especially for the 10-19 age group.

Stress and sleep: impact of the main contributing factors to poor sleep experiences during the COVID-19 pandemic

IntroductionThe COVID-19 (Coronavirus Disease 2019) pandemic is associated with several stressful factors that can negatively affect peoples’ sleep quality and mental health.ObjectivesThe aim of the current study was to prospectively identify decreased sleep quality and associated risk factors in general population during COVID-19 pandemic.MethodsWe conducted a prospective, observational online study on a Romanian sample of 667 respondents aged >18 years. Sleep quality and quantity was evaluated with Athens Insomnia scale (AIS) and the main concerns associated with the pandemic context were evaluated through a multiple-choice question.ResultsThe data collected identified important evidence regarding the prevalence and intensity of insomnia. The average score for AIS was 6.13 (cut-off point for was set at 8). However, it is worth noting that 179 respondents (26.8%) meet the criteria for insomnia. Of the 8 self-assessment items, daytime sleepiness was the criterion evaluated with the highest average score (1.01), all other items getting subunit values. A low quality of sleep was linearly related with fear of illness/death (p=0.053), fear of illness/death of close people (p=0.032), social isolation (p<0.001), economic impact (p=0.003), losing the job (p<0.001) and social stigma associated with COVID-19 infection (p=0.009).ConclusionsMore than a qurter of respondes scored above the threshold of 8 at the insomnia scale, while losing the job, social stigma associated with COVID-19 infection and social isolation are the main risk factors for a low quality and quantity of sleep.DisclosureNo significant relationships.

The relationships between FLAIS, a novel insulin sensitivity index, and cardiovascular risk factors in a population-based study

BackgroundInsulin resistance is a risk factor for cardiovascular disease. Recently, we have developed a novel index, FLAIS (Fasting Laboratory Assessment of Insulin Sensitivity), which accurately reflects insulin sensitivity, measured with hyperinsulinemic-euglycemic clamp, in different groups of subjects. The aim of the present study was to assess the relationship of FLAIS with cardiovascular risk factors in a population-based study.MethodsThe study group comprised 339 individuals from the ongoing Białystok Plus study, without previously known diabetes. Clinical examination, oral glucose tolerance test and the measurement of blood laboratory parameters were performed.ResultsPrediabetes (impaired fasting glucose and/or impaired glucose tolerance) was diagnosed in 165 individuals whereas type 2 diabetes was diagnosed in 19 subjects. FLAIS was lower in individuals with prediabetes and diabetes in comparison with individuals with normal glucose tolerance. FLAIS was significantly related to waist circumference, systolic and diastolic blood pressure, triglycerides, HDL-cholesterol and LDL-cholesterol in the entire study group and in the subgroups with normal glucose tolerance and with prediabetes/diabetes. HOMA-IR, QUICKI and Matsuda index were not related to blood pressure and LDL-cholesterol in individuals with normal glucose tolerance. Majority of the adjusted models with FLAIS were characterized by better fit with the data in comparison with other indices for all cardiovascular risk factors except waist circumference.ConclusionsFLAIS represents useful index to assess the cluster of insulin resistance-associated cardiovascular risk factors in general population.

Prevalence of Hepatitis B and C Along with Associated Risk Factors in General Population of Sena Damin District Jhelum Valley Azad Jammu and Kashmir

Prevalence of Hepatitis B and C Along with Associated Risk Factors in General Population of Sena Damin District Jhelum Valley Azad Jammu and Kashmir

Abstract 9572: Changes of the Incidence of Cardiovascular Risk Factors in General Population During the Covid-19 Pandemic

Background: To examine influence of COVID-19 pandemic on cardiovascular risk factors in general population, incidence of newly diagnosed hypertension, diabetes mellitus, hypercholesterolemia and excess body weight during the COVID-19 pandemic period was compared with that of those before the pandemic period. Methods: Annual incidence of hypertension, diabetes mellitus, hypercholesterolemia and excess body weight was evaluated in subjects who had annual health checkup offered to adult citizens of Moriguchi city, Osaka, Japan in 2019 and 2020. Those with history of cardiovascular disease were excluded. The incidence was compared with that of those who received the checkup in 2018 and 2019 as the control value. The incidence of each risk factor was evaluated in separate models in which subjects with the risk factor of interest at baseline were excluded. Multivariate logistic regression analyses were performed adjusted for clinical valuables including age, sex, hypertension, diabetes, current smoking, drinking habit and excess body weight in each model. Results: Characteristics of the subjects at baseline and incidence of the risk factor next year in each model were presented in the table. The incidence of hypertension (odds ratio (OR)=1.45, 95% confidence interval (CI)=1.29 to 1.64, p<0.0001), hypercholesterolemia (OR=1.55, 95% CI=1.37 to 1.76, p<0.0001), and excess body weight (OR=1.50, 95% CI=1.23 to 1.82, p<0.0001) from 2019 to 2020 was significantly higher compared to that from 2018 to 2019 but that of diabetes was not increased (OR=0.94, 95% CI=0.71 to 1.24, p=0.6648). Conclusions: Increased incidence of hypertension, hypercholesterolemia, and excess body weight was observed during the COVID-19 pandemic period.

Machine learning models for screening carotid atherosclerosis in asymptomatic adults

Carotid atherosclerosis (CAS) is a risk factor for cardiovascular and cerebrovascular events, but duplex ultrasonography isn’t recommended in routine screening for asymptomatic populations according to medical guidelines. We aim to develop machine learning models to screen CAS in asymptomatic adults. A total of 2732 asymptomatic subjects for routine physical examination in our hospital were included in the study. We developed machine learning models to classify subjects with or without CAS using decision tree, random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM) and multilayer perceptron (MLP) with 17 candidate features. The performance of models was assessed on the testing dataset. The model using MLP achieved the highest accuracy (0.748), positive predictive value (0.743), F1 score (0.742), area under receiver operating characteristic curve (AUC) (0.766) and Kappa score (0.445) among all classifiers. It’s followed by models using XGBoost and SVM. In conclusion, the model using MLP is the best one to screen CAS in asymptomatic adults based on the results from routine physical examination, followed by using XGBoost and SVM. Those models may provide an effective and applicable method for physician and primary care doctors to screen asymptomatic CAS without risk factors in general population, and improve risk predictions and preventions of cardiovascular and cerebrovascular events in asymptomatic adults.

Comparison of risk factors for coronary event in people with unattributed and non-coronary chest pain: an electronic health record cohort study

Abstract Background Patients presenting to primary care with chest pain are often not given a cause. Patients with such unattributed chest pain have an increased risk of future cardiovascular disease (CVD) compared to patients with diagnosed non-coronary chest pain. It is unknown whether risk factors for CVD determined in the general population are the same for the population with unattributed or non-coronary chest pain. Purpose To determine if key risk factors for a coronary event in patients with unattributed chest pain are similar to those for patients with non-coronary chest pain and previously identified in the general population. Methods The study used primary care information from the Clinical Practice Research Datalink Aurum linked to hospital inpatient and mortality data. Patients aged ≥18 years with an incident record of unattributed or non-coronary chest pain in 2002–2018 and no diagnosis of CVD were included. We included as potential risk factors those established for CVD in the general population and non-coronary explanations for chest pain. Flexible parametric models estimated hazard ratios (95% confidence intervals (CI)) between factors and incident coronary event (defined as myocardial infarction, angina, coronary heart disease, percutaneous intervention, and coronary artery bypass graft surgery). Results There were 375,240 patients with unattributed chest pain (53% female: mean age 49; 47% male: mean age 47) and 245,329 patients with non-coronary chest pain (58% female: mean age 47; 42% male: mean age 44). Median duration of follow-up was 5 years. In the unattributed chest pain group, there were 111 (95% CI: 109, 112) and 140 (138, 142) coronary events per 10,000 person-years in females and males, respectively. Lower rates of coronary event were observed in the non-coronary chest pain group (females: 73 (72, 75); males: 96 (94, 98)). Within females (Figure), in both chest pain groups the strongest risk factors were type I and type II diabetes, atrial fibrillation, and hypertension whereas no associations were observed for migraine and chronic kidney disease. Whilst alternative explanations for non-coronary chest pain also increased the risk of coronary events, associations were less strong than for established general population risk factors. Similar findings were found in males although family history of coronary event was a stronger risk factor in the non-coronary chest pain group compared to the unattributed chest pain group. Conclusions The pool of factors found to increase the risk of coronary events in patients presenting with recorded unattributed or non-coronary chest pain are similar but not identical to those identified for the general population. Further research is needed to develop prognostic models to identify patients at the most risk of a coronary event as models developed in the general population are unlikely to be applicable given the increased underlying risk of coronary events in these populations. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Study funded by the British Heart Foundation, reference PG/19/46/34307. KJ also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands). Risk factors for coronary event

Association of Asymptomatic Low Ankle-Brachial Index with Long-Term Clinical Outcomes in Patients after Acute Myocardial Infarction.

Aims: Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle–brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute myocardial infarction (AMI) yet. The purpose of this retrospective study was to examine whether asymptomatic low ABI was associated with long-term clinical outcomes in AMI patients without treatment history of PAD. Methods: We included 850 AMI patients without a history of PAD and divided them into the preserved ABI (ABI ≥ 0.9) group (n=760) and the reduced ABI (ABI ＜0.9) group (n=90) on the basis of the ABI measurement during the hospitalization. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction, and hospitalization for heart failure. Results: During the median follow-up duration of 497 days (Q1: 219 days to Q3: 929 days), a total of 152 MACE were observed. The Kaplan–Meier curves showed that MACE were more frequently observed in the reduced ABI group than in the preserved ABI group (p＜0.001). The multivariate COX hazard analysis revealed that reduced ABI was significantly associated with MACE (hazard ratio 2.046, 95% confidence interval 1.344–3.144,p=0.001) after controlling confounding factors. Conclusions: Reduced ABI was significantly associated with long-term adverse events in AMI patients without a history of PAD. Our results suggest the usefulness of ABI as a prognostic marker in AMI patients irrespective of symptomatic PAD.

All-cause mortality among patients treated with repurposed antivirals and antibiotics for COVID-19 in Mexico City: A real-world observational study.

The aim of our study was to evaluate all-cause mortality risk in patients with laboratory-confirmed COVID-19 in Mexico City treated with repurposed antivirals and antibiotics. This real-world retrospective cohort study contemplated 395,343 patients evaluated for suspected COVID-19 between February 24 and September 14, 2020 in 688 primary-to-tertiary medical units in Mexico City. Patients were included with a positive RT-PCR for SARS-CoV-2; those receiving unspecified antivirals, excluded; and groups of antivirals prescribed in < 30 patients, eliminated. Survival and mortality risks were determined for patients receiving antivirals, antibiotics, both, or none. We assessed the effect of early (<2 days) versus late (>2 days) use of antivirals on mortality in a sub-cohort of patients. Multivariable adjustment, propensity score matching, generalized estimating equations, and calculation of E-values were performed to limit confounding. 136,855 patients were analyzed; mean age 44.2 (SD:16.8) years; 51.3 % were men. 16.6 % received antivirals (3 %), antibiotics (10 %), or both (3.6 %). Antivirals studied were Oseltamivir (n=8414), Amantadine (n=319), Lopinavir-Ritonavir (n=100), Rimantadine (n=61), Zanamivir (n=39), and Acyclovir (n=36). Survival with antivirals (73.7 %, p<0.0001) and antibiotics (85.8 %, p<0.0001) was lower than no antiviral/antibiotic (93.6 %). After multivariable adjustment, increased risk of death occurred with antivirals (HR=1.72, 95 % CI: 1.61-1.84) in ambulatory (HR=4.7, 95 % CI: 3.94-5.62) and non-critical (HR=2.03, 95 % CI: 1.86-2.21) patients. Oseltamivir increased mortality risk in the general population (HR=1.72, 95 % CI: 1.61-1.84), ambulatory (HR=4.79, 95 % CI: 4.01-5.75), non-critical (HR=2.05, 95 % CI: 1.88-2.23), and pregnancy (HR=8.35, 95 % CI: 1.77-39.30); as well as hospitalized (HR=1.13, 95 % CI: 1.01-1.26) and critical patients (HR=1.22, 95 % CI: 1.05-1.43) after propensity score-matching. Early versus late oseltamivir did not modify the risk. Antibiotics were a risk factor in general population (HR=1.13, 95 % CI: 1.08-1.19) and pediatrics (HR=4.22, 95 % CI: 2.01-8.86), but a protective factor in hospitalized (HR=0.81, 95 % CI: 0.77-0.86) and critical patients (HR=0.67, 95 % CI: 0.63-0.72). No significant benefit for repurposed antivirals was observed; oseltamivir was associated with increased mortality. Antibiotics increased mortality risk in the general population but may increase survival in hospitalized and critical patients.

Risk Factors for Stroke in Rural Population of Telangana State of India, an Unmatched Case Control Study.

Context Stroke tops the list of causes for acquired disability among adults and is the second leading cause of death worldwide. Evidence from developed countries indicate significant decline in stroke incidence and mortality, attributable to prevention of risk factors in general population. There is limited evidence on risk factors for stroke in rural India. Aims This study aims to ascertain the risk factors for stroke in rural Telangana and provide a guide to health care providers in adopting treatment and prevention strategies. Settings and Design The study was conducted in the Moinabad mandal of Ranga Reddy District, Telangana state of India. This is a population based unmatched case–control study. Methods and Materials All the houses of Moinabad were approached by a door-to-door survey to identify cases. A total of 288 persons were enrolled in the study which included 144 cases and 144 controls. Statistical Analysis To derive age and gender adjusted odds ratios of various risk factors, binary logistic regression analysis was performed. Results The estimated crude prevalence of stroke in Moinabad mandal is 257 per lakh population. Modifiable risk factors identified were, total cholesterol, systolic blood pressure, alcohol consumption, smoking, diastolic blood pressure, low high-density lipoprotein cholesterol, and central obesity as measured by waist circumference. Nonmodifiable risk factors identified were male gender and higher age group. Conclusion The high prevalence of stroke in rural Telangana makes it an important public health challenge for the state. The identified risk factors need to be addressed at population level.

Epidemiology and clinical characteristics of atrial fibrillation in patients with inherited heart diseases.

The prevalence and clinical course of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) is well described, though less so for other inherited cardiomyopathies (familial dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, left ventricular noncompaction); and inherited arrhythmia syndromes (long QT syndrome, Brugada syndrome or catecholaminergic polymorphic ventricular tachycardia [CPVT]). We examined the frequency, clinical characteristics and AF-related management and outcomes amongst this patient population. We retrospectively studied consecutive probands with inherited cardiomyopathy (n = 962) and inherited arrhythmia syndromes (n = 195) evaluated between 2002 and 2018. AF was observed in 5% to 31% of patients, with the highest frequency in HCM. Age of AF onset was 45.8 ± 21.9 years in the inherited arrhythmia syndromes compared with 53.3 ± 15.3 years in the inherited cardiomyopathies, with four CPVT patients developing AF at a median age of 20 years. Overall, 11% of patients with AF had a transient ischemic attack or stroke of which a total of 80% were anticoagulated; with 48% of events occurring at a CHA2 DS2 -VASc < 2. Amongst sarcomere-positive HCM, AF was independently associated with age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02-1.08; P = .0014), left atrial area (OR, 1.11; 95% CI, 1.05-1.17; P = .0005) and MYH7 variants (OR, 2.55; 95% CI, 1.16-5.61; P = .020). Up to one-third of inherited heart disease patients will develop AF. While common general population risk factors are key in patients with HCM, the genotype is independently associated with AF. Amongst inherited arrhythmia syndromes, AF is less common, though often occurs below the age of 50 years.

Population Attributable Risk of Tuberculosis Vulnerabilities in Kerala, India.

Background:A robust disaggregated understanding of the determinants of tuberculosis (TB) in each local setting is essential for effective health system and policy action to control TB.Objectives:The objective of the study was to identify population attributable risk (PAR) for TB disease based on the locally available evidences for Kerala, India.Methods:Systematic review was done for risk factors of TB in the state. The second set of searches was done to understand the prevalence of the identified risk factors in general population in Kerala. With all available studies and reports, an expert group consensus was made to finalize state-specific prevalence of risk factors. Population attributable fractions were calculated for identified risk factors.Results:PAR for TB disease in Kerala obtained was 24% for undernutrition, 15% for diabetes, 15% for tobacco use, and 1% for HIV.Conclusion:Kerala state's PAR for TB was comparatively lower for HIV but higher for diabetes mellitus. Similar exercises for summarizing population risk factors need to happen at all states for making plans to effectively combat TB.

EZETYMIB JAKO LECZENIE DYSLIPIDEMII W PRZEWLEKŁEJ CHOROBIE NEREK

Cardiovascular disease is the leading cause of death among patients with chronic kidney disease (CKD). Primary and secondary prevention of cardiovascular events is one of the major CKD patients' treatment targets. Dyslipidaemia is the important modifiable risk factor in general population. Each 1.0 mmol reduction in LDL cholesterol with statins reduces annual rate of heart attack, coronary revascularization or ischemic stroke by 20% leading to 10% reduction of all-cause mortality. Adding ezetimibe, an inhibitor of intestinal lipids absorption, further reduces LDL cholesterol by 20%. Optimal lipid lowering treatment for CKD patients remains unclear. Cardiovascular risk reduction observed with statins therapy decreases together with a progression of the disease, moreover patients with advanced CKD treated with high doses of statins have an increased risk of adverse events. These patients might benefit from adding ezetimibe to moderate dose statin therapy for prevention of cardiovascular events.

P2507Role of “Walk with a doc” program practice in total risk approach to prevention of cardiovascular disease in RF

Abstract Background It is known that life-style related factors are the main risk factors for CVD morbidity and mortality. In countries with economies in transition (such as Russia) many efforts were aimed at CVD diagnostic and treatment procedures improvement, but lack of primary prevention strategies is observed in general population. CVD morbidity and mortality could be prevented through population based strategies. Purpose To evaluate the feasibility and potency of implementing “Walk with a doc” program practice using newly-developed “Cardiac numbers Diary” for estimation of the individual risk on making decision about whether to initiate specific preventive action to reduce CVD morbidity. Methods The program has successfully started in Moscow, RF in July 2012 as a Russian branch of the global “Walk with a doc” activity. As of January 2019 there are 1576 participants in the database. Special “Cardiac numbers Diary” was developed and includes special charts to allow the introduction of the total risk stratification approach for management of CVD. The charts use a modelling approach with age, sex, physical activity, smoking, blood pressure, body weight, blood glucose and cholesterol. With support of center specialists the weekly events are carried out in different open space grounds and include the assessment of the above risk factors, life style modifying counseling including lectures and 35–40 minutes' walk at the moderate pace. 150 participants participated in more than 20 walks mean age 58,2 years old (±17,1) were assessed in this prospective study. They were assessed for risk factors modifying in 6 months follow-up period. At the moment of inclusion 37.5% participants had arterial hypertension, 12.1% were smokers, 20.2% were overweight. The official Walk-with-a-doc movement is registered in RF. Special Web site provides information on future events, physician team, life-style, diet, physical activity recommendations, photo materials and etc. Results After 6 month of regular walking the number of hypertensive participants decreased to 20.2%. 9.4% of all participants were able to lose weight by 1–6 kg, and 33.3% quit smoking. 75% of people who walked noticed an increase in the level of physical activity. 17.3% of them underwent inpatient treatment using high-tech medical care. Ther were no major events in the above cohort of patients. Conclusions “Walk with a doc” program practice using newly-developed individual “Cardiac numbers Diary” for a predicted individual risk with regular professional counseling can be a useful guide for making clinical decisions on the intensity of preventive interventions to reduce cardiovascular risk factors in general population. Acknowledgement/Funding None

Metabolic Syndrome and Myocardial Involvement in HIV-Infected Patients

Abstract The current HAART has modified natural history of HIV infection and it has practically turned the disease into a manageable chronic condition. Even though the benefits of HAART use are overwhelmingly greater than possible metabolic syndrome and cardiovascular disease risks, close management of those patients is called for, especially due to the fact that general population risk factors now overlap with specific ones in this population. Cardiovascular screening for HIV-infected patients who are receiving HAART must be done constantly with a collaboration between the infectious disease specialist and the internist.

Chronic kidney disease in rheumatoid arthritis patients: prevalence, risks factors, histopathological variants

The present review is focused on risk factors of chronic kidney disease in rheumatoid arthritis (RA). According to recent data, the chronic kidney disease (CKD) in RA patients is more often than at patients without RA. It is closely associated with risk of cardiovascular disease and high mortality. Besides of general population risk factors of CKD, the activity of the disease is independent predictors of reduction in glomerular filtration rate less than 60 ml/min/1.73 m2. In the review, histopathological variants and mechanisms of CKD on basis of international experience are also considered. Suppression of inflammation by basic therapy of RA and biological therapy have changed outcomes RA, prevalence, and structure of kidney involvement in recent years.

Acute Pancreatitis in Chronic Dialysis Patients.

The annual incidence of acute pancreatitis (AP) ranges from 4.9 to 73.4 cases per 100,000 worldwide. Patients with end-stage renal disease on dialysis have an increased risk for developing AP compared with patients without renal disease. In addition to the general population risk factors, there are factors related to renal insufficiency and dialysis process that might predispose to AP in this population. Clinical features and diagnosis are the same as those in patients without renal failure; however, amylase and lipase levels should be interpreted cautiously as they might be falsely elevated in renal failure. In this article, we will describe the risk factors that are exclusive to this population. In addition, we will also focus on the laboratory indices and clinical features that are unique to this population with patients with end-stage renal disease.

Population Attributable Fraction of Stroke Risk Factors in Thailand: Utilization of Non-communicable Disease Surveillance Systems

In Thailand, stroke is the third leading cause of death. The objective of this study was to measure the impacts of behavioral risk and underlying disease factors on stroke. The study design was a case-cohort study comparing prevalence of demographic characteristics and risk factors between stroke patients and general population. We obtained data of stroke patients and risk factors in general population of 12 provinces from two non-communicable disease surveillance systems to calculate population-attributable fraction: the national health information system for morbidity and mortality surveillance, and the behavioral risk factor surveillance system. Multiple logistic regression, based on weighted data and adjusted for clustering effect in each province, was carried out. It was found that approximately 41.6% (95% CI = 35.1-46.2) of stroke in Thai population was related to hypertension. From an age group-specific model, among those aged 15-34 years, smoking carried the highest population attributable fraction of stroke, 32.7% (95% CI = 3.9-40.4). This study demonstrates that impact measurement of stroke risk factors could help devise stroke prevention and control strategies to tackle influential factors. In Thailand, hypertension control program should be a priority in middle and old age groups whereas smoking prevention should be emphasized in young people.

Awareness of Lung Cancer Symptoms and Risk Factors in General Population

Introduction: Lung cancer is often diagnosed in a late stage, which might be related to lack of risk factors and symptoms awareness. Aim of this study was to evaluate these factors. Methods: A survey was conducted to assess the awareness of lung cancer risk factors and symptoms. Kruskal-Wallis, Fisher and chi-square tests were used to compare the groups. Results: Altogether 403 participants (108 male; median age 29 (range 13 to 74) years; 98 smokers, 90 ex-smokers and 212 non-smokers) completed the survey (321 filled in online questionnaire, 82 were interviewed face-to-face). Three per cent of the respondents were unable to name any lung cancer risk factor, 36% named one and 61% named two or more. Smoking was mentioned most commonly, others far less often. When presented with a list of lung cancer risk factors, 99.7% of respondents recognised two or more; most commonly smoking (99%) and second-hand smoking (95%). Concerning symptoms, 17% were unable to name any, 21% named one and 62% named two or more. Prolonged cough was mentioned most often (59%), followed by dyspnea (45%) and chest pain (30%). When presented with a list, 99% of respondents recognised two or more symptoms; most often prolonged cough (86%), weakness (85%) and chest pain (82%). There were no statistical differences in lung cancer symptom, risk factor or prognosis awareness among smokers, ex-smokers and non-smokers. There were some differences related to age, sex, education and type of used questionnaire. Conclusions: Awareness of lung cancer risks and symptoms is moderate in general population without major differences between smokers and non-smokers.