Diabetes, Hypertension, Atrial Fibrillation and Subsequent Stroke-Shift towards Young Ages in Brunei Darussalam

Abstract

Southeast Asia harbors a young population of more than 600 million people. Socioeconomic transition within the last decades, driven by globalization and rapid economic growth, has led to significant changes in lifestyle and nutrition in many countries of this region. Hence, an increase in the number of non-communicable diseases is seen in most populations of Southeast Asia. Brunei Darussalam is the smallest country in this region, with a population of around 400,000 inhabitants. Vast hydrocarbon resources have transformed Brunei into a wealthy industrialized country within the last few decades. We compared the age distribution and prevalence of cardiovascular risk factors in ischemic stroke patients between the only stroke unit in Brunei Darussalam and a tertiary stroke center from Frankfurt/Germany. Between 2011 and 2016, a total number of 3877 ischemic stroke patients were treated in both institutions. Even after adjusting for age due to different population demographics, stroke patients in Brunei were younger compared to their German counterparts. The prevalence of hypertension and diabetes mellitus was significantly higher in young age groups in Brunei, whereas no difference was observed for older patients. The rapid socioeconomic transition might be a significant risk factor for the development of non-communicable diseases, including stroke.

Statement from the Asia Summit: Current state of arrhythmia care in Asia

“…There are few published data on the prevalence of arrhythmias in Brunei Darussalam, but approximately 25.3% of stroke patients had AF, which is comparable to findings in a matched German population 10 . In addition, other data suggest that survival from cardiac arrests remains very low (1.4%), with low rates of bystander cardiopulmonary resuscitation 11 .…”

“…[3][4][5][6] There are few published data on the prevalence of arrhythmias in Brunei Darussalam, but approximately 25.3% of stroke patients had AF, which is comparable to findings in a matched German population. 10 In addition, other data suggest that survival from cardiac arrests remains very low (1.4%), with low rates of bystander cardiopulmonary resuscitation. 11 According to the 2022 APHRS White Book, 61 pacemakers, 18 cardiac resynchronization therapy (CRT) devices, and 27 implantable cardioverter defibrillators (ICDs) were implanted.…”

Electronic Medical Record Data Analysis and Prediction of Stroke Disease Using Explainable Artificial Intelligence (XAI)

“…It may be because hypertension and heart disease has not been detected before, and a stroke occurs suddenly in someone without realising it. Hypertension and heart disease are leading causes of stroke [34]. Hypertension occurs when the blood vessels are not relaxed enough [35].…”

“…Hypertension occurs when the blood vessels are not relaxed enough [35]. It creates a higher resistance to pumping blood through the circulatory system, including the heart [34]. Therefore, hypertension affects the health conditions of the heart and blood vessels that can cause stroke [35].…”

Statement from the Asia Summit: Current state of arrhythmia care in Asia

“…There are few published data on the prevalence of arrhythmias in Brunei Darussalam, but approximately 25.3% of stroke patients had AF, which is comparable to findings in a matched German population. 10 In addition, other data suggest that survival from cardiac arrests remains very low (1.4%), with low rates of bystander cardiopulmonary resuscitation. 11 According to the 2022 APHRS White Book, 61 pacemakers, 18 cardiac resynchronization therapy (CRT) devices, and 27 implantable cardioverter defibrillators (ICDs) were implanted.…”