Modifiable Risk Factors for Stroke in Syria: A Nationwide Multi-centre Case-Control Study

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Stroke is a leading global cause of death and disability.
• Approximately 90% of strokes are linked to modifiable risk factors.
• Effective stroke prevention requires understanding population-specific risk factors.

Purpose of the Study:

• To investigate primary stroke risk factors in Syria, a region with limited research.
• To identify modifiable risk factors for both ischemic and hemorrhagic stroke.
• To assess the prevalence of medication non-adherence in stroke patients.

Main Methods:

• A nationwide, multicenter case-controlled study was conducted across six stroke centers in Syria.
• Data were collected from 411 stroke cases (363 ischemic, 48 hemorrhagic) and matched controls.
• Information was gathered through case files, interviews, and questionnaires.

Main Results:

• Ischemic stroke was significantly associated with atrial fibrillation, high BMI (overweight/obesity), hypercholesterolemia, hypertension, and diabetes mellitus.
• Lifestyle factors like alcohol consumption, poor diet, and low physical activity also contributed to ischemic stroke.
• Hemorrhagic stroke was linked to higher BMI, hypertension, diabetes mellitus, and atrial fibrillation. Over 40% of patients showed medication non-adherence.

Conclusions:

• Key modifiable stroke risk factors in Syria include hypertension, diabetes, atrial fibrillation, and obesity.
• High rates of medication non-adherence, particularly among hypertensive patients, pose a significant challenge.
• Urgent, tailored public health interventions promoting lifestyle changes and medication adherence are crucial for reducing Syria's stroke burden.