Location
AKU Auditorium
Start Date
26-2-2014 12:35 PM
COinS
Feb 26th, 12:35 PM
Feb 26th, 12:45 PM
Prevalence, Correlates and Current Practices for Prevention of Stroke in Hypertensive Population in Karachi, Pakistan
AKU Auditorium
Description
Introduction: Cerebrovascular diseases have become the leading cause of death and disability in both high and low-middle income countries (LMICs). In South Asia itself, age standardized mortality death rates from NCDs including cardiovascular diseases and strokes have surpassed those from communicable and other conditions. Hypertension confers the greatest attributable risk compounded by concomitant diabetes and risky lifestyle behaviors. Lack of awareness and inadequate control of hypertension further aggravate the situation. We aimed to determine the prevalence, associated co-morbidities and the current practices for stroke prevention in hypertensive population in in Karachi.
Methods: We analyzed cross sectional data on adults aged 40 and over to determine the prevalence and correlates of chronic diseases including CVD among adults from 22 low-resource representative communities in Karachi. Stroke was defined as self-reported physician diagnosed stroke. The prevalence, associated factors and existing use of therapies for prevention of stroke were evaluated. Multivariable model was built and logistic regression analysis was performed to determine the factors associated with prevalent stroke.
Results: of the 2,817 hypertensive adults, 103 [(3.70%, (95% CI: 3.30%-4.40%)] reported physician diagnosed stroke. The demographic, lifestyle and clinical factors, including female gender [0.61, (0.39-0.96)], being sedentary [2.07, (1.05-4.06)], diabetes [1.93, (1.22-3.04)] and lack of antihypertensive medication use [2.06, (1.36-3.12)] were independently associated with prevalent stroke.
Conclusions: Stroke is common, despite a significant burden of stroke and associated co-morbidities, the risk factors are poorly controlled and access to preventive therapy remains sub-optimal among individuals with hypertension in Karachi, Pakistan. Our findings highlight the need for urgent efforts for primary and secondary prevention of stroke in high-risk populations in Pakistan and other LMICs. Culturally sensitive, accessible, feasible, affordable and sustainable preventive strategies are critical for the prevention and control of NCDs in high risk population.
Keywords: hypertensive adults, physician diagnosed stroke, prevalence