Differences Of Risk Factors For Ischemic Stroke In Urban And Rural Residents In Northern China

Objective:Based on the National 2016”High-risk Population Screening and Intervention Project for Stroke”,make clear as far as possible the urban-rural differences in the characteristics of ischemic stroke and the distribution of risk factors,providing data support for effective targeted prevention and control.Methods:A total of 100 urban and rural screening sites have been selected in 12 provinces,municipalities,and autonomous regions including Shanxi,Liaoning,and Inner Mongolia in northern China for cross-sectional study design and cluster sampling.Permanent residents aged 40 and above are the target population.According to” The Comprehensive Intervention Questionnaire of 2016 Cardiovascular and Cerebrovascular Disease Risk Factors in Urban and Rural Population”,we will collect information on demographic information,lifestyle,and past medical history for those who meet the criteria.After data cleaning,a total of 192,131 residents were screened and 5539 patients with cerebral infarction were selected.Among non-cerebral infarction patients,5,539 control groups with similar gender,age,and regional distribution were selected.Study their demographic characteristics,and analyze exposures and differences in stroke risk factors.Results:1.There were 5539(2.88%)patients with ischemic stroke,2280(2.43%)in urban areas,3259(3.32%)in rural areas,and the prevalence of rural population was greater than that of urban.Among them,there were 2761(3.06%)men and 2778(2.73%)women,the prevalence in males is greater than that in females.The ischemic stroke population in rural areas is younger,and their education and income levels are significantly lower than those in urban areas.2.Hypertension,family history of stroke,smoking,dyslipidemia,diabetes and lack of exercise are common independent risk factors for ischemic stroke in urban and rural areas.Obviously overweight and obesity and lower education levels are independent risk factors of urban ischemic stroke.Atrial fibrillation is an independent risk factor for ischemic stroke in rural areas,and lower education level is its protective factor.3.Hypertension is the most common risk factor for ischemic stroke in urban and rural areas.Alcoholism,dyslipidemia,diabetes,overweight and obesity are more common in urban populations of ischemic stroke,while high salt diet,low education and income are more prevalent in rural areas.The rate of smoking exposure is higher in male disease groups,among which the city is higher than rural areas.4.In the ischemic stroke group,hypertension and dyslipidemia are common in the elderly population.Among which,smoking and alcohol abuse are common in the 50-59 age group,and lack of exercise is higher in populations who are 40-49 or ≥70-year-old in city.Diabetes is prevalent in the elderly population in village.In addition,we also found the proportion of overweight and obesity decreases with age,while the tendency of lack of exercise is the opposite in rural areas.5.Chronic diseases,smoking and alcohol consumption of ischemic stroke groups in urban and rural areas: the duration of hypertension,diabetes mellitus and dyslipidemia is longer and the rate of treatment is higher in urban areas.The urban drinking people have a longer time and a higher rate of heavy drinking,while the rural smoking groups have a significantly higher smoking index.Conclusion:1.The prevalence of ischemic stroke in people aged 40 years and above in northern China is higher than the national average,with rural areas being higher than urban areas and males being higher than females.2.High blood pressure is the focus of prevention and treatment of ischemic stroke.Since the high salt diet is grim,the action of salt reduction should be advocated in northern China,especially in rural areas.In addition,men should pay attention to smoking cessation.3.In the urban population,attention should be paid to the prevention and treatment of dyslipidemia and diabetes,avoiding high fat intake and heavy drinking,while rural areas should conduct more health education lectures to popularize knowledge of stroke,enhance residents’ awareness of prevention and control,and cultivate good living habits.4.People with higher levels of education in rural areas in northern China should also be concerned.