Risk Factors for Incident Stroke and Its Subtypes in China: A Prospective Study.
Risk Factors for Incident Stroke and Its Subtypes in China: A Prospective Study.
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中国脑卒中及其亚型的危险因素：一项前瞻性研究
DOI：
10.1161/jaha.120.016352
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发表时间：
2020-11-03
影响因子：
5.4
通讯作者：
Liu Y
中科院分区：
文献类型：
--
作者：
Qi W;Ma J;Guan T;Zhao D;Abu-Hanna A;Schut M;Chao B;Wang L;Liu Y
背景管理风险因素对预防卒中至关重要。然而，在中国，很少有队列研究将社会经济因素与影响卒中及其亚型的传统因素一起进行评估。方法和结果中国国家卒中筛查和干预项目的一项2014年至2016年前瞻性研究包括437318名年龄≥40岁的基线无卒中的成年人。在2.1年的中位随访期内，有2429例首次卒中病例，包括2206例缺血性卒中和237例出血性卒中。多因素考克斯回归分析显示，年龄50 ~ 59岁（相对于40-49岁），小学或未受过正规教育（与中学相比），有1个以上子女（与1个孩子相比），居住在东北、华中、华东或华北地区（与中国西南地区相比），缺乏体力活动，高血压，糖尿病，和肥胖与总卒中和缺血性卒中的风险呈正相关，而年龄60 - 69岁和与配偶或子女同住（与独居相比）与总卒中和缺血性卒中的风险呈负相关。男性、素食、体重不足、缺乏运动、高血压、生活在高收入地区、参加城镇居民基本医疗保险和新型农村合作医疗与出血性脑卒中风险呈正相关，而年龄60 - 69岁与出血性脑卒中风险呈负相关。结论：我们确定了补充卒中及其亚型的传统危险因素的社会经济因素，允许针对这些因素减少卒中负担。
Background Managing risk factors is crucial to prevent stroke. However, few cohort studies have evaluated socioeconomic factors together with conventional factors affecting incident stroke and its subtypes in China. Methods and Results A 2014 to 2016 prospective study from the China National Stroke Screening and Intervention Program comprised 437 318 adults aged ≥40 years without stroke at baseline. There were 2429 cases of first‐ever stroke during a median follow‐up period of 2.1 years, including 2206 ischemic strokes and 237 hemorrhagic strokes. The multivariable Cox regression analysis indicated that age 50 to 59 years (versus 40–49 years), primary school or no formal education (versus middle school), having >1 child (versus 1 child), living in Northeast, Central, East, or North China (versus Southwest China), physical inactivity, hypertension, diabetes mellitus, and obesity were positively associated with the risk of total and ischemic stroke, whereas age 60 to 69 years and living with spouse or children (versus living alone) were negatively associated with the risk of total and ischemic stroke. Men, vegetable‐based diet, underweight, physical inactivity, hypertension, living in a high‐income region, having Urban Resident Basic Medical Insurance, and New Rural Cooperative Medical System were positively associated with the risk of hemorrhagic stroke, whereas age 60 to 69 years was negatively associated with the risk of hemorrhagic stroke. Conclusions We identified socioeconomic factors that complement traditional risk factors for incident stroke and its subtypes, allowing targeting these factors to reduce stroke burden.