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The Risk of Stroke in Physicians: A Population-based Cohort Study in Taiwan
Hon-Pheng Tam1, Hung-Jung Lin, Shih-Feng Weng
1From the aDepartment of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; bDepartment of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan; cDepartment of Emergency Medicine, Taipei Medical University, Taipei, Taiwan; dDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; eDepartment of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; fDepartment of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; gDepartment of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan; hDepartment of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; iBachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan; jDepartment of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan; and kDepartment of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Background:
Physicians in Taiwan work in stressful workplaces and have heavy workloads, both of which may contribute to the occurrence of a stroke. However, it is not clear whether they have a higher risk of stroke. Therefore, we conducted a population-based cohort study to compare the risks of stroke between physicians and the general population and among subgroups of physicians in Taiwan.
Methods:
In the National Health Insurance Research Database of Taiwan, we identified 28,062 physicians and selected 84,186 age- and sex-matched nonmedical staff beneficiaries as the references. Using conditional logistic regression, we compared the prevalence of stroke between physicians and references. In addition, we made comparisons among subgroup of physicians defined by age, sex, comorbidity, specialty, and the level of hospital.
Results:
During the study period, physicians had higher prevalence rates of hypertension (23.6% vs. 19.1%), hyperlipidemia (21.4% vs. 12.9%), and coronary artery disease (CAD) (6.4% vs. 5.7%) than the referent group, but they had a lower risk of stroke with an odds ratio of 0.61 (95% confidence interval = 0.55, 0.66) after adjusting for hypertension, diabetes, hyperlipidemia, CAD, and active worker. Among physicians, the risks were higher in those who were older or had hypertension, diabetes, hyperlipidemia, or CAD.
Conclusions:
Despite having higher prevalence rates of hypertension, hyperlipidemia, and CAD and working in stressful workplaces with heavy workloads, our study suggests that physicians in Taiwan have a lower risk of stroke compared with the general population. These results may indicate the benefits of higher awareness and more knowledge of diseases.