Deoke Aniruddha, Deoke Shilpa, Saoji Ajeet, Hajare Shilpa
Department of Community Medicine, NKR Salve Insitutitu of Medical Sciences and Research Center, Nagpur, India.
Glob J Health Sci. 2012 Apr 28;4(3):158-63. doi: 10.5539/gjhs.v4n3p158.
Stroke, a major public health problem in India and worldwide, is associated with many risk factors. The modification of risk factors, an important public health strategy, has been shown to reduce the risk of stroke. Hence the present study was carried out to document the risk factor profile of stroke.
It was a case-control study. Patients with stroke admitted in a tertiary care centre in central India and age and sex matched controls were included. Detail history and clinical examination was done in all cases and controls. The risk factors studied were education, socioeconomic status (according to Kuppuswamy's classification), level of physical activity, alcohol intake, and smoking, tobacco chewing, family history of stroke and history of systemic hypertension, transient ischemic attack or ischemic heart disease. Anthropometric (weight, height, body mass index and waist circumference) measurements were done in all patients. Electrocardiogram was done in cases as well as controls and abnormalities noted.
The data was analyzed using Epi info version 3.4.1 software. Chi-square test was used as test of significance and p value less than 0.05 was considered as significant.
On comparing the cases with controls, sedentary life-style (p=0.02), history of transient ischemic attack (p=0.002), coronary artery disease (p=0.014), family history of stroke (p=0.001), systemic hypertension (p<0.001) and ECG abnormalities (p=0.04) were significant risk factors whereas low socio-economic status (p=0.40), smoking (p=0.12), tobacco chewing (p=0.35), alcohol consumption (p=0.22), obesity [both central and generalized as assessed by waist circumference (p=0.33) and BMI respectively (p=0.43)] and Diabetes mellitus (p=0.07) were not found to be statistically significant risk factors. The most significant risk factor was systemic hypertension (OR= 15.92, 95% CI, 1.78-6.85) followed by coronary artery disease (OR=3.86, 95% CI, 1.13-14.50), abnormal ECG (OR=2.49, 95% CI, 0.97-6.96) and sedentary life-style (OR=2.41, 95% CI, 1.07-5.49).
In the present hospital based case control study in patients with stroke, sedentary life-style, history of transient ischemic attack, family history of stroke, coronary artery disease, systemic hypertension and abnormal ECG were significant risk factors. This could be helpful in early identification of subjects at risk for stroke and formulating public health strategy, if proven by larger population based studies.
中风是印度乃至全球的一个主要公共卫生问题，与许多风险因素相关。改变风险因素作为一项重要的公共卫生策略，已被证明可降低中风风险。因此，开展本研究以记录中风的风险因素概况。
这是一项病例对照研究。纳入了印度中部一家三级护理中心收治的中风患者以及年龄和性别匹配的对照组。对所有病例和对照进行了详细的病史询问和临床检查。研究的风险因素包括教育程度、社会经济地位（根据库普苏瓦米分类法）、身体活动水平、饮酒、吸烟、咀嚼烟草、中风家族史以及系统性高血压、短暂性脑缺血发作或缺血性心脏病史。对所有患者进行了人体测量（体重、身高、体重指数和腰围）。对病例组和对照组均进行了心电图检查并记录异常情况。
使用Epi info 3.4.1版软件对数据进行分析。采用卡方检验作为显著性检验，p值小于0.05被认为具有显著性。
将病例组与对照组进行比较，久坐的生活方式（p = 0.02）、短暂性脑缺血发作史（p = 0.002）、冠状动脉疾病（p = 0.014）、中风家族史（p = 0.001）、系统性高血压（p < 0.001）和心电图异常（p = 0.04）是显著的风险因素，而社会经济地位低（p = 0.40）、吸烟（p = 0.12）、咀嚼烟草（p = 0.35）饮酒（p = 0.22）、肥胖[通过腰围评估的中心性肥胖和全身性肥胖，p分别为0.33和体重指数（p = 0.43）]以及糖尿病（p = 0.07）未被发现是具有统计学意义的风险因素。最显著的风险因素是系统性高血压（OR = 15.92，95%可信区间，1.78 - 6.85），其次是冠状动脉疾病（OR = 3.86，95%可信区间，1.13 - 14.50）、心电图异常（OR = 2.49, 95%可信区间，0.97 - 6.96）和久坐的生活方式（OR = 2.41，95%可信区间，1.07 - 5.49）。
在本次基于医院的中风患者病例对照研究中，久坐的生活方式、短暂性脑缺血发作史、中风家族史、冠状动脉疾病、系统性高血压和心电图异常是显著的风险因素。如果通过更大规模的基于人群的研究得到证实，这可能有助于早期识别中风高危人群并制定公共卫生策略。
