Waist Hip Ratio in Ischemic Stroke Patients Admitted in a Tertiary Hospital: A Case Control Study

Abdominal obesity, measured by waist-to-hip ratio, is an independent, potent risk factor for Ischemic Stroke. Risk of stroke can be minimized through primordial prevention. The study was conducted to assess the high waist hip ratio as a risk factor for Ischemic Stroke. A case control study was conducted with IRB approval in the department of Medicine and Neurology, Mymensingh Medical College Hospital for a period of six months with 100 admitted Ischaemic Stroke cases selected purposively following inclusion and exclusion criteria with equal number of age-sex matched pair controls from patients' relatives, hospital staffs and admitted patients other than Ischaemic Stroke. Waist-hip ratio was calculated by dividing the waist circumference with the hip circumference. Socio-demographic, clinical, biochemical and haematological data were collected as well. Informed written consent was obtained from the participants or their guardians/attendants for interview, physical measurements and taking blood samples for biochemical examinations. Data were collected by principal investigator using case record form and interview schedule. All the relevant ethical issues and measures for data quality were taken into consideration. Data were analyzed by using SPSS version-17.0, and presented in tables and figures. Mean age of the cases and controls was 63.4±2.0 years with a male-female ratio of 3:2. Of cases, 35(35.0%) were house-wives and 32(32.0%) were Farmers, while of controls, 40(40.0%) were house-wives and 23(23.0%) were farmers. Left hemisphere 58(58.0%), and cerebral cortex 48(48.0%) were commonly involved areas of the brain. Hemiplegia (57.0%) and hemi-paresis (31.0%) were commonplace with exacerbated ankle jerk (60.0%) and extension planter response (55.0%). As many as 12(12.0%) cases and 16(16.0%) controls were diabetic (p>0.05) with 7(7.0%) cases and 1(1.0%) control had past history of Ischemic Heart Disease (p<0.05). 59(59.0%) cases and 33(33.0%) controls had Systolic Hypertension (p<0.001), while 48(48.0%) cases and 21(21.0%) controls had Diastolic Hypertension (p<0.0001). Seventy-five (75.0%) cases and 30(30.0%) controls had high waist-hip ratio (p<0.001). At least 39(39.0%) cases and 37(37.0%) controls had high total cholesterol level (p>0.05), whereas 52(52.0%) cases and 30(30.0%) controls had low HDL cholesterol level (p<0.0001), 54(54.0%) cases and 46(46.0%) controls had high LDL cholesterol level (p>0.05) and 63(63.0%) cases and 37(37.0%) controls had high triglyceride level (p>0.05). Waist-hip ratio is high among cases with high statistical significance. A significant number of cases and controls are with total cholesterol and high LDL, low HDL and high TG levels.