Risk factors for stroke among urbanised Indonesian women of reproductive age: a hospital-based case-control study

Stroke is a major cause of death in South-East Asia, but few empirical data exist on its risks in Asian populations.

235 cases and 682 age-matched controls of women of reproductive age (20-44 years) were recruited in 14 hospitals in Jakarta, Indonesia, between 1989 and 1993. Medical history was collected by a structured interview. In subsamples, glucosuria, serum cholesterol level and body mass index (BMI) were assessed.

In these young and lean Muslim women, with few users of tobacco, alcohol or oral contraceptives, risk factors related to increased weight were strongly related to stroke occurrence. A history of hypertension or diabetes or increased serum cholesterol level showed odds ratios (ORs) of 13.9, 7.4 and 3.7, respectively. A BMI >27 (unadjusted for its potential consequences) caused an OR of 2.9. High social class and higher level of education (both OR 0.7) were associated with a lower risk of stroke, but levels of risk factors were higher in higher socio-economic classes.

The expected transition in lifestyle, characterised by a higher intake of calories and less physical activity, will increase stroke risks in Indonesian women. Increasing wealth should go together with raising levels of health education on nutrition and physical activity.