Stroke risk and its association with quality of life: a cross-sectional study among Chinese urban adults

Abstract

Background Stroke is a leading cause of mortality and disability worldwide. Most stroke risk studies focused on more established biological and pathophysiological risk factors such as hypertension and smoking, psychosocial factors such as quality of life are often under-investigated and thus less reported. The current study aims to estimate stroke risk and explore the impact of quality of life on stroke risk among a community sample of urban residents in Shanghai. Methods This cross-sectional study was conducted in Fengxian District of Shanghai City from December 2018 to April 2019. 4030 representative participants were recruited through a multistage, stratified, probability proportional to size sampling method and completed the study. Stroke risk was assessed using the Rapid Stroke Risk Screening Chart that included 8 risk factors for stroke. Quality of life was measured using the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Results One-third of residents were at risk for stroke, including 14.39% at high risk, and 18.68% at middle risk. The top three most commonly reported risk factors were physical inactivity (37.30%), hypertension (25.38%), and smoking (17.32%). Quality of life and its four domains were all independently and significantly associated with stroke risk. Multinominal logistic regressions showed that a one-unit increase in the quality of life was associated with a decreased relative risk for middle-risk relative to low-risk of stroke by a factor of 0.988 (95% CI:0.979, 0.997, P = 0.007), and a decreased relative risk for high-risk relative to low-risk of stroke by a factor of 0.975 (95% CI:0.966, 0.984, P < 0.001). Conclusions Our findings showed an alarmingly high prevalence of stroke risk among the sample, which may require future intervention programs to focus on improving both biological and behavioral risk factors such as increasing physical activity, early diagnosis and treatment of hypertension, and smoking cessation, as well as improving psychosocial factors such as quality of life.

Depression, Anxiety, Stress, and Their Associations With Quality of Life in a Nationwide Sample of Psychiatrists in China During the COVID-19 Pandemic

“…Of note, unlike most other studies (Suarez et al, 2018 ; Yao et al, 2021 ; Yen et al, 2022 ), this study only used two items (i.e., general quality of life and general health state) instead of the four domains (i.e., physical health, psychological, social relationships, and environment) to evaluate QOL. Our findings support the feasibility of these two separate items in assessing the overall QOL (Haag et al, 2017 ; Li et al, 2021b ).…”

“…In addition, the cross-sectional design precludes us from making causal interpretations. Fourth, this study used only two separate items to assess the overall QOL, which may be considered less comprehensive as the ones that used the four-domain instrument (Suarez et al, 2018;Yao et al, 2021;Yen et al, 2022), and it may also limit the generalizability of our findings. Finally, due to differences in work environment and exposures between diverse medical specialties and across countries, the generalizability of the findings to other populations deserves further investigation.…”

A Cross-Sectional Study: Determining Factors of Functional Independence and Quality of Life of Patients One Month after Having Suffered a Stroke

“…However, other very important points for the prediction of the prognosis in the recovery of patients are the determinants of functional capacity and QoL. Major risk factors include physical inactivity, hypertension, smoking, dyslipidemia and obesity [37][38][39], which may clarify the results found in our study: 42% of the sample had hypertension, 76.5% of them did not perform physical exercise and 12.3% were habitual tobacco users.…”

“…The high incidence and the burden of stroke disease indicate the importance of urgent control of risk factors for the prevention of stroke [37]. However, other very important points for the prediction of the prognosis in the recovery of patients are the determinants of functional capacity and QoL.…”

Sexual Harassment Among Chinese Psychiatrists and Its Impact on Quality of Life: A Cross-Sectional Survey [Response to Letter]

“…We greatly appreciate the interest shown by Yao et al in our research, 1 as well as the valuable comments and suggestions they have provided. 2 We also sincerely thank them for summarizing the advantages of our article.…”