Determinants of Stroke in Brazil: A Cross-Sectional Multivariate Approach from the National Health Survey

J Stroke Cerebrovasc Dis. 2018 Jun;27(6):1616-1623. doi: 10.1016/j.jstrokecerebrovasdis.2018.01.013. Epub 2018 Feb 14.

Abstract

Objective: The objective of this study was to investigate the association between biological-health, socioeconomics, and behavioral determinants and stroke by evaluating the risk of stroke in the presence of each or all determinants grouped in a multivariate model.

Methods: This study is a transversal secondary data analysis of the Brazilian National Health Survey, released by the Brazilian Institute of Geography and Statistics. The prevalence, prevalence ratios, and confidence intervals were calculated for the main outcome. A multivariate regression model was applied, with the stroke as outcome and all other variables with a P value of .20 or lower in the univariate analysis included as explanatory variables to adjust for potential confounders and effect modifiers.

Results: The mean age was 43.3 ± 16.6 years, ranging from 18 to 101 years. The prevalence of hypertension was 21.4%, and with regard to lifestyle habits, it was observed that 20.0% had smoked but stopped and 29.7% practiced physical activity in the last 30 days. The regression model showed that the odds ratio in the final model was weighted, with low schooling, smoking habit, overweight, low physical activity practice, diabetes, and hypertension being significantly associated with stroke.

Conclusion: The multivariate model showed that the chance of stroke is high, both combined or isolated.

Keywords: Stroke; cardiovascular diseases; epidemiology; risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Chi-Square Distribution
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Educational Status
  • Exercise
  • Female
  • Health Surveys
  • Humans
  • Hypertension / epidemiology
  • Life Style*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / epidemiology
  • Odds Ratio
  • Prevalence
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking Cessation
  • Socioeconomic Factors*
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Time Factors
  • Young Adult