The Incidence And Influence Factors Of Stroke Among Hypertensive Patients In Rural Areas Of Liaoning Province

Objectives: The incidence of stroke has increased significantly in hypertensive patients,and the burden of disease has been greater in rural areas.Therefore,the purpose of this study was to explore the incidence of stroke and its influencing factors in hypertensive patients in rural areas of Fuxin,Liaoning.Methods: This study is a prospective cohort study.From 2004 to 2006,5097 hypertensive patients without baseline cardiovascular disease completed the follow-up with a median follow-up of 8.5 years.Multivariate Cox proportional hazard models were used to analyze the potential influencing factors of stroke and calculate the hazard ratios(HR)and 95% confidence interval(CI).The adjusted variables include age,gender,ethnicity,smoking,drinking,systolic blood pressure(SBP),diastolic blood pressure,body mass index(BMI),physical activity,education level,blood lipids,blood glucose,history of diabetes,history of hyperlipidemia,family history of hypertension and antihypertensive medications.Results: A total of 501 new strokes occurred during the follow-up period(310ischemic strokes,186 hemorrhagic strokes,and 5 were unclassified).The crude incidence of total stroke,ischemic stroke and hemorrhagic stroke was 12.35,7.64,and4.59/1000 person-years,respectively.The Cox proportional hazard models showed statistical significance in female(HR: 0.44;95%CI:0.36-0.55),age(HR: 1.02,95%CI:1.01-1.03),SBP(HR: 1.02,95%CI: 1.01-1.02),antihypertensive drugs(HR: 1.65,95%CI: 1.35-2.01),low-density lipoprotein cholesterol levels(HR: 1.41,95%CI:1.05-1.89),BMI(HR: 0.97,95%CI: 0.94-1.00)and education levels(elementary and below as the reference,the HR(95%CI)of junior high school and high school and above were 0.73(0.58-0.90)and 0.61(0.40-0.91),respectively).Subgroup analyses and sensitivity analyses excluding those taking antihypertensive drugs yielded similar results.Conclusions: The incidence of stroke is higher in the hypertensive population in rural Fuxin,Liaoning.A variety of traditional risk factors affect the occurrence of stroke.In the future,more targeted measures will be needed to reduce the significant disease burden caused by stroke.