Income level is associated with differences in primary and secondary stroke prevention in China

The aim of this study was to assess differences in the effects of income level on the primary and secondary prevention of stroke in the Chinese population.

This was a population-based study using data from a China Kadoorie Biobank survey that began in 2004 in 10 geographical regions. Community residents (n = 512,715) aged 30-79 years were recruited. Stroke was determined by the self-reporting of a doctor's diagnosis, and participants with a high risk of stroke were identified using the model developed in the Prediction for ASCVD Risk in China study.

The final numbers of people included in this study were 8,884 with stroke and 218,972 with a high risk of stroke. The participants' income level was positively associated with high levels of physical activity and the consumption of a healthy diet, but negatively associated with the control of alcohol consumption (all p < 0.05). In addition, positive associations were observed between the control of smoking and the use of antiplatelet and antihypertensive medication for primary prevention (all p < 0.05), but there was a negative association with the control of blood pressure (p < 0.001).

Low-income individuals were less likely to control smoking and their diet and use preventive medications, while high-income individuals were less likely to control their alcohol consumption and blood pressure. Moreover, medication use was low for both primary and secondary prevention in high-income individuals.