Prevalence Rates Of Stroke Research Articles

1280-P: Use of Machine Learning to Determine the Relative Influence (RI) of Genetic Risk Scores of Glycemic Traits on Myocardial Infarction and Stroke in 409,633 Participants in the UK Biobank

Introduction: Genome-wide association studies have identified numerous glycemic traits-associated SNPs with myocardial infarction (MI) and stroke. However, conventional regression methods combining these large numbers of highly significant SNPs in a weighted genetic risk score (wGRS) have only explained a small proportion of variance in MI and stroke. Therefore, we used a machine-learning algorithm (gradient boosting) to test the association of genetic risk for glycemic traits with MI and stroke in the UK Biobank population. Methods: We identified 4626 SNPs associated with glycemic traits from the NGHRI catalogue for GWAS studies. wGRS were calculated using the effect estimates from the GWAS studies. We used a gradient-boosting machine-learning (GBM) model to identify the relative influence (RI) of baseline variables and wGRS of the glycemic traits on prevalent stroke and MI in the UK Biobank population. Results: The study consisted of 409,633 individuals (53% females) with a median age of 58 (51-63) years and a median BMI of 26.7 (24.1-29.8) kg/m2. The prevalence rates of MI and stroke were 3.6% and 2.3%. In the GBM model, top wGRS associated with MI were type 2 diabetes (RI=14.6) , blood glucose levels adjusted for fasting time (RI=12.2) and beta-cell glucose sensitivity (RI=10.06) . In contrast, the top wGRS associated with stroke were HbA1c (RI=12.13) and fasting insulin levels (RI=10.31) . The addition of wGRS’s to the model comprising the baseline characteristics slightly improved the AUC for predicting stroke and MI. Conclusion: We showed a differential effect of wGRS for various glycemic traits on the risk of MI and stroke in the UK Biobank population. However, even in machine learning models, these wGRS for various glycemic traits had a limited utility in predicting stroke and MI in the general population. Disclosure H.Deshmukh: None. M.Miles: None. A.Bhaiji: None. N.Shah: None. S.Akbar: None. M.Papageorgiou: None. T.Sathyapalan: n/a. Funding NIHR Clinical Lectureship

The burden of stroke and its attributable risk factors in the Middle East and North Africa region, 1990\u20132019

Stroke is one of the leading causes of mortality and morbidity across the globe. Providing comprehensive data on the burden of stroke in the Middle East and North Africa (MENA) could be useful for health policy makers in the region. Therefore, this article reported the burden of stroke and its attributable risk factors between 1990 and 2019 by age, sex, type of stroke, and socio-demographic index. Data on the point prevalence, death, and disability-adjusted life-years (DALYs), due to stroke, were retrieved from the Global Burden of Disease study 2019 for the 21 countries located in the MENA region from 1990 to 2019. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals (UIs). In 2019, the regional age-standardised point prevalence and death rates of stroke were 1537.5 (95% UI: 1421.9–1659.9) and 87.7 (78.2–97.6) per 100,000, which represent a 0.5% (− 2.3 to 1.1) and 27.8% (− 35.4 to − 16) decrease since 1990, respectively. Moreover, the regional age-standardised DALY rate in 2019 was 1826.2 (1635.3–2026.2) per 100,000, a 32.0% (− 39.1 to − 23.3) decrease since 1990. In 2019, Afghanistan [3498.2 (2508.8–4500.4)] and Lebanon [752.9 (593.3–935.9)] had the highest and lowest age-standardised DALY rates, respectively. Regionally, the total number of stroke cases were highest in the 60–64 age group and was more prevalent in women in all age groups. In addition, there was a general negative association between SDI and the burden of stoke from 1990 to 2019. Also, in 2019, high systolic blood pressure [53.5%], high body mass index [39.4%] and ambient particulate air pollution [27.1%] made the three largest contributions to the burden of stroke in the MENA region. The stroke burden has decreased in the MENA region over the last three decades, although there are large inter-country differences. Preventive programs should be implemented which focus on metabolic risk factors, especially among older females in low SDI countries.

Abstract TP187: Contemporary Estimates Of Poor Cardiovascular Health Among Individuals With Stroke: Nationwide Analysis Of The American Heart Association’s Simple 7

Introduction: The American Heart Association’s (AHA) “Simple 7” are lifestyle behaviors for maintenance of ideal cardiovascular health (CVH). Methods: We analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data (nationally representative, annual, health-related survey of community dwelling US adults), and flagged individuals with a stroke diagnosis. Among stroke individuals (SI), we identified validated CVH features (diabetes, hypertension, BMI ≥ 25 kg/m 2 , hypercholesterolemia, smoking, poor eating habits, and lack of exercise) based on AHA’s simple 7. SI with ≥ 5 CVH features were categorized as ‘Poor CVH’ (PCVH). We evaluated socio-demographic, regional and healthcare utilization factors associated with PCVH. We fit survey design logistic regression models, and report nationally representative estimates as adjusted Odds Ratios (aOR) and 95% confidence intervals (CI). Results: The 2019 estimated national count of SI is 8,570,876 translating into a nationwide stroke prevalence of 3.4% among US adults (7.9% among ≥ 65 years). SI who were divorced/separated (vs. married), non-Hispanic Black or Native American (vs. Non-Hispanic White - NHW), had lower income, resided in the stroke belt had higher likelihood of PCVH. In our adjusted model (Figure), males had a significantly higher PCVH aOR (CI) 1.26 (1.00 - 1.59). Moreover, Asian American and Pacific Islanders vs. NHW demonstrated higher PCVH, aOR (CI) 4.74 (1.25 - 17.95). Compared to the New England region, residence in following divisions was associated with higher PCVH; aOR (CI) for West South-Central: 1.73 (1.05 -2.85), East North Central: 1.64 (1.11 - 2.43), East South Central: 2.29 (1.37 - 3.83), South Atlantic: 1.74 (1.18 - 2.57). Analyses for 2020 BRFSS data will be presented. Conclusion: National stroke prevalence rates are provided. Poor CVH among stroke individuals continues to be disparately high. These analyses are important to identify and target high-risk population sub-groups.

A Systemic Review of the Integral Role of TRPM2 in Ischemic Stroke: From Upstream Risk Factors to Ultimate Neuronal Death.

Ischemic stroke causes a heavy health burden worldwide, with over 10 million new cases every year. Despite the high prevalence and mortality rate of ischemic stroke, the underlying molecular mechanisms for the common etiological factors of ischemic stroke and ischemic stroke itself remain unclear, which results in insufficient preventive strategies and ineffective treatments for this devastating disease. In this review, we demonstrate that transient receptor potential cation channel, subfamily M, member 2 (TRPM2), a non-selective ion channel activated by oxidative stress, is actively involved in all the important steps in the etiology and pathology of ischemic stroke. TRPM2 could be a promising target in screening more effective prophylactic strategies and therapeutic medications for ischemic stroke.

Increased Prevalence of Myocardial Infarction and Stable Stroke Proportions in Patients with Inflammatory Bowel Diseases in Quebec in 1996-2015.

Background: Chronic inflammatory diseases are linked to an increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is controversial. We therefore examined the risk of and risk factors for myocardial infarction (MI) and stroke in IBD patients. Methods: We used the public health administrative database from the Province of Quebec, Canada, to identify IBD patients newly diagnosed between 1996 and 2015. The incidence and prevalence of MI and stroke in IBD patients were compared to those for the Canadian population. Results: A cohort of 35,985 IBD patients was identified. The prevalence but not incidence rates of MI were higher in IBD patients (prevalence: 3.98%; incidence: 0.234) compared to the Canadian rates (prevalence: 2.0%; incidence: 0.220), while the prevalence and incidence rates of stroke were not significantly higher in the IBD patients (prevalence: 2.98%; incidence: 0.122, vs. Canadian rates: prevalence: 2.60%; incidence: 0.297). We identified age, female gender, hyperlipidemia, diabetes, and hypertension (p < 0.001 for each) as significant risk factors associated with MI and stroke in IBD. Exposure to biologics was associated with a higher incidence of MI (IRR: 1.51; 95% CI: 0.82–2.76; p = 0.07) in the insured IBD population. Conclusions: An increased prevalence but not incidence of MI and no increased risk of stroke were identified in this population-based IBD cohort.

Associations Between Active Commuting and Cardiovascular Disease in the United States.

Active commuting is inversely related with cardiovascular disease (CVD) risk factors yet associations with CVD prevalence in the US population are unknown. Aggregate data from national surveys conducted in 2017 provided state-level percentages of adults who have/had coronary heart disease, myocardial infarction, and stroke, and who actively commuted to work. Associations between active commuting and CVD prevalence rates were assessed using Pearson correlations and generalized additive models controlling for covariates. Significant correlations were observed between active commuting and all CVD rates (r range = -.31 to -.47; P < .05). The generalized additive model analyses for active commuting (walking, cycling, or public transport) in all adults found no relationships with CVD rates; however, a significant curvilinear association was observed for stroke within men. The generalized additive model curves when examining commuting via walking or cycling in all adults demonstrated nuanced, generally negative linear or curvilinear associations between coronary heart disease, myocardial infarction, and stroke. Significant negative correlations were observed between active commuting and prevalence rates of coronary heart disease, myocardial infarction, and stroke. Controlling for covariates influenced these associations and highlights the need for future research to explore the potential of active commuting modes to reduce CVD in the United States.

Demographic information and risk factors of stroke patients younger than 65 years old

Objective: The main objective of this study is to evaluate the prevalence of risk factors for and demographics of patients younger than 65 years old with stroke.&#x0D; Methods: This retrospective cross-sectional study took into consideration all patients younger than 65 years old who were admitted to the emergency department from 2016 to 2018. Some significant criteria such as age, sex, type of stroke, stroke risk factors, and modified Ranking Scale (mRS) were extracted from patients’ medical records. Based on their age, these patients were divided into three groups: younger than 35 years old (Group A), between 35-50 years old (Group B), and older than 50 years old (Group C). Data analysis was carried out using IBM® SPSS® Statistics 20.0 software.&#x0D; Results: A total of 392 patients with stroke were included in this study. Groups A, B, and C included 31, 124, and 237 patients, respectively. Among them, 313 patients (79.84%) were admitted to the hospital in cold seasons, while 73 patients (18.6%) had no symptoms related to stroke at the time of admission. The most common adjustable risk factor among the patients was hypertension (HTN) with a frequency of 230 (58.7%). Of note, the frequency of HTN, diabetes, atrial fibrillation (AF), oral contraceptive pill (OCP) consumption, and coronary artery disease (CAD) in patients was significantly different among these three groups.&#x0D; Conclusion: According to the findings of the present study, the prevalence rate of stroke probably varies for male and female (gender) in the studied groups, which is significantly correlated with age. Among the adjustable risk factors for stroke, HTN, diabetes, AF, OCP consumption, and CAD are significantly correlated with the age.

Increased risk of stroke in patients with diffuse idiopathic skeletal hyperostosis: a nationwide population-based cohort study

Diffuse idiopathic skeletal hyperostosis (DISH) is frequently an incidental finding during X-ray examination. Although it has been shown to be associated with several chronic diseases, the hazard of cerebrovascular disease has seldom been explored. Our study aimed at determining the risk of stroke conferred by DISH, which is a retrospective cohort study adopting the largest medical database in Taiwan. Patients with a diagnosis of DISH at least three times from 2005 to 2010 were identified as the study group, and those in the control group were selected by matching age and gender. Patients were followed up until the end of 2015 to trace the incidence of stroke. Cox regression analysis was performed to compute the hazard ratio of stroke. Among the included 5300 patients, 1060 had a diagnosis of DISH. Significantly higher prevalence rates of stroke, hypertension, diabetes, and hyperlipidemia were noted in these patients. Overall, DISH conferred a 1.68 times higher risk of developing stroke. The significantly higher hazard ratio could be identified in both genders whether hypertension existed or not. Even in those without comorbidities, DISH still conferred a significantly higher risk of cerebrovascular disease in the future, which should never be ignored when encountered during clinical practice.

Comparison the Impact on TENS and Conventional Physiotherapy in Stroke Patients with Upper Limb Dysfunctions: A Research Protocol

Background: Stroke is a sudden neurological explosion resulting from poor blood flow perfusion to the brain. Stroke prevalence rates in India are expected to range from eighty-four to two hundred sixty-two strokes every 100,000 persons in remote regions and from three hundred thirty-four to four hundred twenty-four strokes every 100,000 persons in metropolitan areas. It causes brain cells to die abruptly due to inadequate oxygen and is a neurological condition characterized by blood flow blockage.&#x0D; Aim &amp; Objective: to examine the impact of TENS (Transcutaneous Electrical Nerve Stimulation), EMS (Electrical Muscle Stimulation), and ROM (Range of Motion) exercises on upper-limb functioning in hemi paretic stroke victims.&#x0D; Methods: The current study subjects (n=39) would be stroke survivors. Patients will be divided into three groups: group A will receive TENS, group B will receive EMS, and group C will get ROM exercises. The protocol will cover 2 weeks of treatment. We will assess upper limb functioning, activities of everyday living (ADLs), and mental condition at frequent intervals. By using the MHQ (Michigan Hand Outcomes Questionnaire), Hand Grip Strength (HGS), Brunnstrom Hand Function Recovery stages.&#x0D; Results: The successful completion of this study will provide evidence on the best treatment strategy for stroke patients to improve their upper extremity motor function using individual TENS, EMS, or ROM exercises.&#x0D; Conclusion: This study will be beneficial to treat Stroke patients with upper limb dysfunction by treating by TENS modality which might be an option for EMS treatment.

AWARENESS OF EARLY WARNING SIGNS OF STROKE IN RURAL AND URBAN POPULATION

The objectives of our study are: 1. To find out the awareness of early warning signs of stroke in rural population. 2. To find out the awareness of early warning signs of stroke in urban population. 3. To find out the difference between the level of awareness in rural and urban population. It was a survey - based study in which the population fulfilling the criteria were given the stroke questionnaire with Prior consent. Based on the responses, the percentage of awareness among the population was calculated. The difference between the level of awareness in rural and urban population was calculated. The total Sample was 162 including rural (81) and urban (81). The sample size was derived using formula . Were, p=44.3%, q=100 - p, L= 12% (p= prevalence rate, q= 100 - p, L= allowable error). Based on stroke questionnaire it was seen that the rural population had more prevalence rate of stroke and were familiar with the term stroke or paralysis whereas urban population (12%) was unaware of the warning signs of the stroke. Awareness was quiet high in Rural Population (19%). The level of awareness was less in both the population but was less in urban population as compared to rural population.

Integrated approach to stroke burden: are we doing enough?

In The Lancet Neurology, the GBD 2019 Stroke Collaborators present data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 that show that annual numbers of stroke have increased globally since 1990, with most of the stroke burden being borne by low-income and middle-income countries. 1 GBD 2019 Stroke CollaboratorsGlobal, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; (published online Sept 3.)https://doi.org/10.1016/S1474-4422(21)00252-0 Google Scholar The age-standardised rate of deaths and disability-adjusted life-years (DALYs) due to stroke in the World Bank low-income group of countries was almost four-times higher than that in the high-income group of countries. Despite an overall decrease in age-standardised rates between 1990 and 2019, a concerning trend is the substantial increase in age-specific stroke incidence and prevalence rates in individuals younger than 70 years. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Full-Text PDF Open Access

Effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients.

The aim of the study was to explore the effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. All patients were divided into Group A and Group B based on different interventions (Group A: acupuncture + conventional rehabilitation, Group B: conventional rehabilitation alone). Acupuncture was conducted once a day, five times a week for 8 weeks, and rehabilitation (including physical therapy and occupational therapy) was conducted for 2 hr per session, once a day, five times a week for 8 weeks. Mini-mental State Examination (MMSE) and Fugl-Meyer Assessment (FMA) were used to assess the motor and cognitive functions at baseline and the end of 8 weeks. After the intervention, FMA and MMSE scores were improved significantly in the two groups (p <.05), compared with the scores prior to intervention. After 8 weeks of intervention, a statistically significant difference in the FMA and MMSE scores was observed between the Group A and the Group B. The results suggested that the combined intervention is more effective than the conventional rehabilitation alone in improving cognitive and motor functions in poststroke patients.

Safety and efficacy of new oral anticoagulants compared to those of warfarin in AF patients with cancer: a meta-analysis of randomized clinical trials and observational studies.

Data on the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with cancer are limited. Therefore, we conducted a meta-analysis to compare the efficacy and safety between NOACs and warfarin in this population. A comprehensive search of the PubMed, Embase, and Cochrane databases for articles published through July 2020 was performed. An evaluation of each study was conducted, and data were extracted. Pooled odds ratio (OR) estimates and 95% CIs were calculated. Eight studies (3 randomized controlled trials (RCTs) and 5 retrospective cohort studies) involving a total of 24,665 patients were included. Among the RCTs, there were no significant differences in the rates of stroke or systemic embolism (OR=0.69; 95% CI, 0.45-1.06; P=0.09), venous thromboembolism (OR=0.91; 95% CI, 0.33-2.52; P=0.86), myocardial infarction (OR=0.74; 95% CI, 0.44-1.23; P=0.24), major bleeding (OR=0.81; 95% CI, 0.61-1.06; P=0.12), or major or nonmajor clinically relevant bleeding (OR= 0.98; 95% CI, 0.82-1.19; P=0.86) between the NOAC and warfarin groups. Among the observational studies, patients who used NOACs had a significantly lower risk than those who used warfarin. The prevalence rates of ischemic stroke (OR=0.51; 95% CI, 0.28-0.92; P=0.02), VTE (OR=0.50; 95% CI, 0.41-0.60; P<0.00001), major bleeding (OR=0.28; 95% CI, 0.14-0.55; P=0.0002), and intracranial or gastrointestinal bleeding (OR=0.59; 95% CI, 0.37-0.92; P=0.02) were significantly reduced in the NOAC group. Our meta-analysis confirms that NOACs are as safe and effective as warfarin and can be applied in the real world; this data can serve as a reference for clinical doctors for formulating treatment strategies.

Hemorrhagic and ischemic stroke in patients with coronavirus disease 2019: incidence, risk factors, and pathogenesis - a systematic review and meta-analysis.

Background: In this study, we aimed to determine the global prevalence, chronological order of symptom appearance, and mortality rates with regard to hemorrhagic and ischemic stroke in patients with coronavirus disease 2019 (COVID-19) and to discuss possible pathogeneses of hemorrhagic and ischemic stroke in individuals with the disease. Methods: We searched the PubMed, Scopus, and Web of Science databases for relevant articles published up to November 8, 2020. Data regarding study characteristics, hemorrhagic stroke, ischemic stroke, and COVID-19 were retrieved in accordance with the PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of the eligible studies. The pooled prevalence and mortality rate of hemorrhagic and ischemic stroke were calculated. Results: The pooled estimate of prevalence of hemorrhagic stroke was 0.46% (95% CI 0.40%-0.53%; I 2 =89.81%) among 67,155 COVID-19 patients and that of ischemic stroke was 1.11% (95% CI 1.03%-1.22%; I 2 =94.07%) among 58,104 COVID-19 patients. Ischemic stroke was more predominant (incidence: 71.58%) than hemorrhagic stroke (incidence: 28.42%) in COVID-19 patients who experienced a stroke. In COVID-19 patients who experienced a stroke, hospital admission with respiratory symptoms was more commonly reported than that with neurological symptoms (20.83% for hemorrhagic stroke and 5.51% for ischemic stroke versus 6.94% for hemorrhagic stroke and 5.33% for ischemic stroke, respectively). The pooled mortality rate of COVID-19 patients who experienced a hemorrhagic and ischemic stroke was 44.72% (95% CI 36.73%-52.98%) and 36.23% (95% CI 30.63%-42.24%), respectively. Conclusions: Although the occurrence of hemorrhagic and ischemic stroke is low, the mortality rates of both stroke types in patients with COVID-19 are concerning, and therefore, despite several potential pathogeneses that have been proposed, studies aimed at definitively elucidating the mechanisms of hemorrhagic and ischemic stroke in individuals with COVID-19 are warranted. PROSPERO registration: CRD42020224470 (04/12/20).

Incidence and Prevalence of Stroke and its Risk Factors in the Philippines: A Systematic Review

Background. Various epidemiologic studies reported different stroke incidence and prevalence rates in the Philippines. Thus, there is a need to synthesize existing information on these indicators to depict more accurate evidence on the burden on stroke in the country. Objective. The objective of this systematic review is to provide evidence on the incidence and prevalence of stroke in the Philippines, as well as its associated risk factors. Methods. PubMed and HERDIN were searched for available full-text Philippine epidemiologic studies on stroke incidence and prevalence, whether population or hospital-based, and its associated risk factors. We used three tools for risk of bias assessment, namely, the Newcastle Ottawa Scale for cohort studies, the Quality assessment checklist of Hoy et al. for cross-sectional prevalence studies, and the AXIS tool for general cross-sectional studies. Results. A total of 14 studies were included in this review. Based on these studies, the national stroke incidence rate ranged from 3.95% to 5.61%, while the national stroke prevalence rate ranged from 0.486% to 6.0%. Hypertension remains the commonly reported risk factor of stroke alongside diabetes, smoking, and high cholesterol level. Conclusions. Despite limitations, we were able to perform a complete assessment of the risk of bias in included studies which provide information on the studies with reliable information. Based on this systematic review, there is variability on data and limited studies on the national epidemiology of stroke in the Philippines. It is recommended that the national government consider establishing a system such as a national registry for better data collection and analysis.

Burden of Stroke in India During 1960 to 2018: A Systematic Review and Meta-Analysis of Community Based Surveys.

Stroke is a heterogeneous disorder comprising of clinical subtypes and many risk factors, also alluded to as cerebrovascular disorders (CVDs). Increase in the global burden of stroke in developed and developing countries has been alarming. To galvanize the efforts towards the prevention and treatment, there is a need for robust data on the burden of stroke. The aim of this study was to estimate the burden of stroke, a systematic review of community-based studies was conducted. Systematic search of PubMed and Google Scholar for studies from January 1960 to December 2018 was done. The articles were screened and the data was retrieved and sorted into incidence, prevalence and mortality rates. Meta-analysis was done on Medcalc statistical software version 19.2.6. Prevalence rate of stroke for total population inclusive of urban and rural population, varied from 44.54 to 150/100000.For the urban population prevalence rate was 45 to 487/100000 and 55 to 388.4/100000 for rural population. The incidence rate varied from 33 to 123/100000 in the urban population and in the rural population it was estimated to be 123.57/100000. The 30 days case fatality rate of stroke varied from 41.08% to 42.06% in urban population and 18% to 46.3%.in the rural population. Systematic review and meta-analysis reveal that the stroke burden in India is quite high.

High BMI: an important health risk factor among older adults in Ghana.

We examined BMI as a health risk factor for self-reported diabetes mellitus, angina, strokes and arthritis among older Ghanaians aged 50 years and above. We analysed the individual-level data from the World Health Organization Study on global AGEing and adult health Ghana Wave 2 (2014/2015). The influence of BMI on self-reported chronic conditions including diabetes, angina, stroke and arthritis was examined. Households from all the administrative regions of Ghana. Included 3350 adults aged 50 years and older. The prevalence of overweight and obesity among participants was 22·8 % (95 % CI 20·6, 25·2) and 13·2 %, respectively (95 % CI 11·5, 15·1). With respect to individual chronic conditions, arthritis emerged with the highest prevalence rate of 7·3 (95 % CI 5·3, 9·9), while the prevalence rate of diabetes, angina and stroke was 2·8 % (95 % CI 2·0, 3·9), 1·7 % (95 % CI 1·1, 2·6) and 1·3 % (95 % CI 1·0, 1·8), respectively. The risk of diabetes among overweight and obesity was over three and two times, respectively, higher compared with participants with normal weights. Overweight and obesity were significantly more than two and three times likely to experience angina, respectively, compared with participants with normal weight. Obesity significantly influences arthritis with approximately two times increased odds compared with normal weight participants. Prevalence of obesity and overweight in Ghana is high and increasing, which poses a health risk at the individual and population levels. Inter-sectorial and multidisciplinary measures in line with the national non-communicable disease policies aimed at curbing this trend are imperative.

All-cause mortality for cohabiting spouses of stroke survivors: Evidence from Swedish national registries

ABSTRACT Background/objectives Spousal concordance for cardiovascular risk factors and lifestyle behaviors may affect prevalence rates of diabetes, hypertension, and stroke. Spouses of stroke survivors, therefore, would be expected to have elevated mortality rates, but this has not been established. Thus, the aim of this study was to investigate whether cohabitant spouses of stroke survivors have higher mortality rates compared to a matched reference cohort. Methods Data for this population-based cohort study were extracted from Swedish national registries from 2010 to 2016. The national sample consisted of 13,049 spouses of first ever stroke survivors and a reference cohort of 51,685 cohabitant individuals from the general population matched by age, gender, and place of residence. Effects on mortality were analyzed using Cox proportional hazard survival analyses. Results Female and male spouses of stroke survivors were found to have 5-year hazard ratios of death of 1.26 (95% confidence interval 1.17, 1.36) and 1.24 (95% confidence interval 1.16, 1.33), respectively, when compared to the reference cohort. Both female and male spouses had higher mortality from diseases in the circulatory system compared to the reference cohort. Conclusion Spouses of stroke survivors have higher mortality rates than a matched reference population that persist for a minimum of 5 years. Policy-makers should acknowledge and address the health status of spouses when evaluating and planning the health and social care of stroke survivors.

Time-series study of cardiovascular rates in India: A systematic analysis between 1990 and 2017

Cardiovascular disease represents a significant public health issue and places an immense burden on India's citizens, families, health systems, and the population. Predictive models provide structure and direction in anticipating future needs. This time-series study employed Box–Jenkins time series modeling to forecast 2030 prevalence and mortality rates of stroke, ischemic heart disease, and cardiovascular disease. The 2030 projected cardiovascular disease prevalence rate was predicted to increase to 5.26% (95% prediction interval, 5.19%–5.28%), with major contributors being stroke and ischemic heart disease. The authors propose increased investment across the continuum of care to efficaciously promote, prevent, and rehabilitate cardiovascular disease.

Efficacy of repetitive peripheral magnetic stimulation on the functional recovery in stroke patients

Abstract © 2018 Institute of Psychiatry, Ain Shams University Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited. Background Optimizing the management of stroke is a national priority. In Egypt, the mean crude prevalence rate of stroke is 721.6/100,000 1of which almost 30 percent suffer from post stroke spasticity. Theta Burst Stimulation (TBS) is a new faster modality of the conventional rTMS that is used to improve functional recovery after stroke. Objective This work was carried out to assess the effects of peripheral TBS in improving the functional recovery of the lower limb after stroke. Patients and methods A case–control study was conducted to include 27 patients with chronic stroke, who were selected from the attendants of the neurology outpatient clinic in Ain Shams University Hospital, along with 19 participants of age-matched and sex-matched stroke patients as a control group. Case and control groups were subjected to neurological and functional assessment using gait assessment rating scale (GARS) at baseline and after the sessions. An informed written consent was taken from patients included in the study. All patients received 6 sessions of peripheral TBS on affected lower limb. Results There was a statistically significant difference between the two groups in the improvement of functional scale (GARS). Conclusion Peripheral TBS improves gait and functional recovery in chronic stroke patients.