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Stroke incidence and risk factors in Havana and Matanzas, Cuba
J C Llibre-Guerra1, A Valhuerdi Cepero2, O Fernández Concepción1
1Departamento de Neurología, Unidad de Ictus, Instituto de Neurología y Neurocirugía, Universidad Médica de La Habana, La Habana, Cuba.
Insights
Stroke incidence in Cuban elderly is 786.2 per 100,000 person-years. Alcohol, dementia, and male sex are key risk factors for stroke in this population.
Area of Science:
- Gerontology
- Neurology
- Epidemiology
Background:
- Cerebrovascular disease is a leading cause of death, disability, and dementia globally.
- Understanding stroke burden in aging populations is crucial for public health initiatives.
Purpose of the Study:
- To determine the incidence rate of stroke.
- To identify risk factors for incident stroke among adults aged 65 and over in Cuba.
Main Methods:
- Prospective longitudinal study of 2916 elderly adults in Cuba (Havana and Matanzas) from 2008-2011.
- Included living subjects and verbal autopsies; analyzed age, sex, education, health, chronic diseases, substance abuse, and APOE genotyping.
- Stroke diagnosed using World Health Organization criteria; incidence calculated by sex, age, and risk factors.
Main Results:
- Stroke incidence rate was 786.2 per 100,000 person-years (95% CI: 672.3-906.4).
- Significant risk factors for incident stroke included history of alcohol consumption (HR: 3.5), dementia (HR: 3.0), and male sex (HR: 1.8).
Conclusions:
- Stroke incidence in this Cuban elderly population is comparable to developed countries and lower than in low- to middle-income countries.
- Further research is needed to analyze the impact of other factors like diabetes, heart disease, hypertension, smoking, and APOE4 on stroke risk.
Introduction:
Cerebrovascular disease is the third-leading cause of death and the second-leading cause of disability and dementia.
Objective:
Determine stroke incidence and risk factors in a population of adults aged 65 and over in Cuba (Havana and Matanzas).
Material And Methods:
This prospective longitudinal study, completed between April 2008 and Abril 2011, re-evaluated 2916 elderly adults with an average follow-up time of 4 years. Cases included 2316 living subjects and 600 verbal autopsies. Study variables were age, sex, educational level, self-reported health, and description of chronic diseases and substance abuse. Laboratory tests included genotyping APOE. Stroke was diagnosed based on the World Health Organization definition. We calculated the global incidence rate for stroke, broken down by sex, age group, and risk factors for incident stroke.
Results:
Stroke incidence was 786.2 in 100000 persons/year (95% CI: 672.3-906.4). History of alcohol consumption (HR: 3.5; 95% CI: 3.3-3.7), dementia (HR: 3.0; 95% CI, 1.6-5.5) and male sex (HR: 1.8; 95% CI, 1.2-2.8) were shown to be risk factors for incident stroke.
Conclusions:
Stroke incidence was similar to rates reported in developed countries and lower than that in low- to middle-income countries. Given that diabetes mellitus, heart disease, arterial hypertension, smoking, APOE4, etc. are associated with higher mortality rates, they will require separate analysis in a study of stroke risk factors.