Risk Factors of the First-Time Stroke in the Southwest of Saudi Arabia: A Case-Control Study

Abstract

Worldwide, stroke is the second leading cause of death and a frequent cause of permanent disability. The objective was to identify the first-time stroke modifiable risk factors in the Aseer region, southwest Saudi Arabia. In a multicenter hospital-based case-control study design, all first stroke patients admitted to hospitals in the Aseer region were included consecutively over one year. Age, sex, and geographical residence-matched controls were selected and included in a ratio of 1:1. Data collected included altitude (low or high), nationality, marital status, educational level, family history of stroke, history of diabetes mellitus, history of systemic hypertension, high cholesterol level, current smoking, obesity, and regular exercise practice. The study included 1249 first-time stroke patients and 1249 age, sex, and residence-matched controls. Hypertension, diabetes mellitus, obesity, and high cholesterol were significantly highly prevalent among cases (57.7%, 49.4%, 42.0%, 29.4%, respectively) compared to controls (31.8%, 25.9%, 30.8%, 12.1%, respectively). Practicing regular exercise was significantly highly prevalent among controls (29.9%) compared to cases (13.1%). Multivariable logistic regression analysis revealed that systemic hypertension (adjusted odds ratio (aOR) = 2.12, 95%CI: 1.74–2.57), diabetes mellitus (aOR = 1.73, 95%CI: 1.41–2.21), obesity (aOR = 1.95, 95%CI: 1.61–2.28) and high cholesterol (aOR = 1.64, 95%CI: 1.28–2.10) were significant risk factors, while regular exercise practice was a significant protective factor (aOR = 0.12, 95%CI: 0.05–0.26) for stroke. Hypertension, diabetes mellitus, obesity, and high cholesterol are major risk factors for stroke in the Aseer region of southwest Saudi Arabia. The protective role of regular physical activity in reducing the risk of stroke is evident. The observed higher prevalence of potentially modifiable risk factors among stroke cases encourages an urgent need to develop and implement a national program to control these factors.

Differences of Lipid Profile Among Ischemic and Hemorrhagic Stroke Patients in a Tertiary Hospital in Riyadh, Saudi Arabia: A Retrospective Cohort Study

“…Multiple studies around the Kingdom found that hypertension and diabetes are major risk factors for stroke. A study done in Gizan found that 45% of stroke patients had hypertension and 28% had diabetes [ 11 ]. Another study done in the Asser region found that hypertension and diabetes were significantly highly prevalent among stroke Saudi patients at 57.7% and 49.4%, respectively [ 4 ].…”

“…Diabetes mellitus was the second reported risk factor for stroke, present in 71% of the patients. According to WHO, Saudi Arabia is the second-highest country in the Middle East and the seventh globally for diabetes [ 11 ]. A tenfold increase in the prevalence of diabetes was noticed in Saudi Arabia over the past 30 years [ 11 - 12 ].…”

“…According to WHO, Saudi Arabia is the second-highest country in the Middle East and the seventh globally for diabetes [ 11 ]. A tenfold increase in the prevalence of diabetes was noticed in Saudi Arabia over the past 30 years [ 11 - 12 ]. The health burden of diabetes and hypertension in Saudi Arabia is expected to increase to a serious level due to stroke.…”

“…The health burden of diabetes and hypertension in Saudi Arabia is expected to increase to a serious level due to stroke. A recent study by Alhazzani revealed that people with diabetes have significantly more than two times the chance to have a stroke compared to non-diabetic patients [ 11 ]. According to a recent study, the awareness of hypertension and diabetes as risk factors for stroke among the general population of Saudi Arabia is low [ 13 ].…”

Faktor-faktor yang Berhubungan dengan Kejadian Stroke pada Penduduk Usia ≥15 Tahun di Provinsi Daerah Istimewa Yogyakarta (Analisis Data Riskesdas 2018)

“…Berbeda dengan penelitian kasus kontrol di Arab Saudi yang menggunakan batas IMT pengkategorian obesitas adalah >30 kg/m 2 menunjukkan bahwa kondisi obesitas dan kejadian stroke memiliki hubungan yang signifikan dan adjusted odd ratio sebesar 1,95. 29 Menurut teori, terdapat beberapa penjelasan hubungan obesitas dengan kejadian stroke. Pertama, kelebihan berat badan dan obesitas berkaitan dengan peradangan sistemik tingkat rendah yang mengakibatkan peningkatan konsentrasi protein Creaktif.…”