Yi Xingyang, Chen Hong, Wang Yanfen, Yu Ming, Luo Hua, Wang Chun, Wei Wei, Chen Xiaorong, Bao Shaozhi
Department of Neurology, The People's Hospital of Deyang City, Deyang, China.
Department of Neurology, The Suining Central Hospital, Suining, China.
Front Neurol. 2022 Mar 2;13:693894. doi: 10.3389/fneur.2022.693894. eCollection 2022.
With the aging of the population and the change of lifestyle in China, the prevalence and risk factors of the high-risk population for stroke may change. However, few studies performed community-based high-risk stroke population surveys in China. Hence, we performed this multicenter, cross-sectional, and community-based survey in Sichuan of southwestern China, according to the China National Stroke Screening Survey (CNSSS) program in 2015. The residents aged ≥ 40 years volunteered to participate in the face-to-face survey in 8 communities in Sichuan. The 8 communities were selected using the cluster randomization method. Subjects with at least three of the eight stroke-related risk factors were classified as a high-risk population for stroke. Otherwise were classified as a low-risk population for stroke. Furthermore, 1,011 individuals were randomly selected among the low-risk population for stroke as controls. Among 16,892 participants, 2,369 (14.0%) were high-risk population for stroke. After full adjustments, all eight risk factors for stroke were significantly associated with the high-risk population for stroke ( < 0.001). The largest contributor was hypertension [population-attributable risk (PAR) 28.4%], followed by physical inactivity (PAR 14.2%), dyslipidemia (PAR 11.2%), overweight/obesity (PAR 9.4%), diabetes (PAR 7.2%), family history (PAR 6.8%), smoking (PAR 5.9%), and atrial fibrillation (PAR 3.5%). Carotid atherosclerosis was more serious in the high-risk population for stroke than in controls ( < 0.05). The prevalence of the high-risk population for stroke was high in southwestern China. Hypertension, physical inactivity, and dyslipidemia were stronger contributors for the high-risk population for stroke. Individual-level and population-level interventions for these leading risk factors are very important for the primary prevention of stroke.
随着中国人口老龄化和生活方式的改变,卒中高危人群的患病率及危险因素可能会发生变化。然而,在中国很少有研究开展基于社区的卒中高危人群调查。因此,我们依据2015年中国国家卒中筛查调查(CNSSS)项目,在西南地区的四川进行了这项多中心、横断面、基于社区的调查。年龄≥40岁的居民自愿参与了四川8个社区的面对面调查。这8个社区采用整群随机抽样方法选取。具有8种卒中相关危险因素中至少3种的受试者被分类为卒中高危人群。否则被分类为卒中低危人群。此外,在卒中低危人群中随机选取1011人作为对照。在16892名参与者中,2369人(14.0%)为卒中高危人群。经过全面校正后,所有8种卒中危险因素均与卒中高危人群显著相关(<0.001)。最大的危险因素是高血压[人群归因危险度(PAR)28.4%],其次是缺乏身体活动(PAR 14.2%)、血脂异常(PAR 11.2%)、超重/肥胖(PAR 9.4%)、糖尿病(PAR 7.2%)、家族史(PAR 6.8%)、吸烟(PAR 5.9%)和心房颤动(PAR 3.5%)。卒中高危人群的颈动脉粥样硬化比对照组更严重(<0.05)。中国西南地区卒中高危人群的患病率较高。高血压、缺乏身体活动和血脂异常是卒中高危人群的更强危险因素。针对这些主要危险因素的个体层面和人群层面干预措施对卒中的一级预防非常重要。