High Burden of Stroke Risk Factors in Developing Country: the Case Study of Bosnia-Herzegovina

Abstract

Introduction:The burden of stroke has been increasing worldwide, especially in developing countries. Very few data regarding epidemiology of stroke are available in Bosnia and Herzegovina (BH).Patients and methods:We undertook a retrospective hospital-based study in all hospitals existing in five cantons and one district of BH. The patients were recruited between January 1st, 2014, and December 31st, 2014, and only first-ever-in-lifetime strokes (FES) were included for evaluation.Results:A FES was diagnosed in 1479 patients (age 71.83 ± 11.703 years) during the study period. FES occurred in 709 men (47.9%; age 69.64 ±12.002 years) and 770 women (52.1%; age 73.85± 11.051 years). Stroke was categorized into ischemic stroke (IS), primary intracerebral hemorrhage (PICH), subarachnoid hemorrhage (SAH) and cerebral venous thrombosis (CVT), which was diagnosed in 84%, 12,2%, 3,4% and 0,4% cases respectively. Early 28-day case-fatality was 18.5 % for all patients and both sexes combined. Short-term case-fatality was significantly greater in women (P=0.007). Among all patients with FES, 87% had hypertension, 35% diabetes mellitus, 39% hypercholesterolemia and almost 25 % atrial fibrillation.Discussion:This is the first study that provides us with information on epidemiology of stroke in BH. More than 90% of patients had one or more modifiable risk factors and the number would be even higher if we included smoking. The early stroke case-fatality was lower than that observed in other low- to middle-income countries.Conclusion:All modifiable stroke risk factors, especially high blood pressure, should be understood as a major public health problem in BH and efforts should be focused on the primary prevention of stroke. Our emphasis is on the designing of a stroke register in BH for a better health planning.

The burden of stroke and modifiable risk factors in Ethiopia: A systemic review and meta-analysis

“…Though hypertension is the main reported modifiable risk factor of stroke among the included primary studies, the pooled proportion of hypertension among stroke patients found in the current study is lower than the previous studies conducted in Burkina Faso [ 59 ], Iran [ 61 ], China [ 58 ], Bosnia-Herzegovina [ 69 ], Nigeria [ 70 ], and Bangladesh [ 71 ]. The possible explanation for this variation might be due to the lack of diagnostic modalities and proficiency, level of income, hypertension awareness, treatment, and control [ 72 ].…”

“…Our review is comparable with a previous study conducted in Nigeria [ 70 ]. However, this estimated proportion of dyslipidemia among stroke patients is lower than a study conducted in Bosnia-Herzegovina [ 69 ], and China [ 58 ].…”

Predicting Functional Outcome Based on Linked Data After Acute Ischemic Stroke: S-SMART Score

“…Second, the score was developed in Korean stroke patients; therefore, evaluation of its reliability in other populations is needed. In addition, the generalization of this score could be limited in low-and middleincome developing countries, because of their lack of acute stroke management systems, combined with inadequate rehabilitation services, and a lack of preventive measures in stroke patients [42][43][44]. Third, participating centers in the CRCS registry were large centers; therefore, there could be limitations related to generalization to community hospitals and small centers.…”

Demencija Nakon Moždanog Udara

“…Svake dvije sekunde neko u svijetu doživi moždani udar, a svakih šest sekundi neko od njega umre. MU pogađa 33 miliona ljudi svake godine u svijetu, a jedna trećina MU se dešava u zemljama u razvoju (2). Međunarodne epidemiološke studije pokazuju da stopa raste eksponencijalno s godinama, od 0,3‰ u trećoj dekadi života, do 30‰ u osamdesetim i devedesetim godinama života, što predstavlja prosjek od 1-2‰.…”