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Clinical characteristics, distribution of risk factors and ischemic stroke subtype among patients of Arab and

Clinical characteristics, distribution of risk factors and ischemic stroke subtype among patients of Arab and

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Ischemic stroke is influenced by ethnic and geographical variations. The aim of this study was to identify the risk factor profiles, subtypes and recurrence of non-cardioembolic ischemic stroke for the two largest subpopulations, the Arab and South Asians, at the only stroke-admitting hospital in Qatar. Data on stroke patients admitted to Hamad Med...

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... clinical characteristics of the Arab and South Asian subgroup of patients are summarized in Table 2. Table 3 summarizes the patients' modifiable cardiovascular risk factor profile: overall hypertension was the most commonly encountered risk factor followed by dyslipidemia, diabetes mellitus, and obesity. ...
Context 2
... addition, Qatari patients had a significant higher prevalence of diabetes mellitus compared to expatriates (67 vs. 49%, p 5 0.003). Significant differences between the Arab and South Asian subgroup of patients were observed with respect to number of risk factors and occurrence of obesity (BMI) and diabetes (Table 2). Although there was a trend of a higher frequency of smokers in the South Asian community, the difference was not statistically significant ( p 5 0.09). ...
Context 3
... this study population there was no significant association between smoking and carotid artery stenosis, but this may be related to the small number of patients in the subpopulations. Carotid artery stenotic lesions, cardiac wall motion abnormalities and stroke recurrence were observed with a higher frequency in the Arab subgroup of patients compared with the South Asians (Table 2). ...

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... In addition, the occurrence of subtypes of ischemic stroke is affected by ethnic and geographical variations. In a previous study performed in Arab and South Asian patients, notable differences between these patients were observed with respect to the number of risk factors for stroke (17). The influence of ethnicity on the occurrence of ischemic subtypes must be considered. ...
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... Hypertension is an important public health challenge worldwide. It contributes to the onset of heart diseases, strokes, kidney failure, premature mortality, and disability (Deleu et al., 2006;WHO, 2013). ...
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... Hamad et al. 17 found their patient cohort to have a mean age of stroke onset of 57 years for males and 60 years in females. We found a relatively young average age of onset of stroke 27 reported a similar finding in a retrospective review of non-cardioembolic stroke patients admitted to HGH (67.3 vs 55.5 years, P ¼ 0.0001). Performing a time-trend analysis using ANOVA and Hochberg GT2 post hoc tests, we found a significantly lower average age of stroke onset in those cases occurring in 2016 than those in 2013, 2014, 2015 and 2017 (F[7, 1175] ¼ 3.688, P ¼ 0.001). ...
... In Khan's 33 observational study focusing on prevalent risk factors involved in young stroke between the ages of 15 and 45 years in Qatar, the top five risk factors included hypertension (40%), diabetes mellitus (32.5%), hypercholesterolemia (27.5%), smoking (27.5%) and alcohol consumption (22.5%). Deleu et al. 27 found that hypertension (69%) was again the most common risk factor among stroke patients, followed by dyslipidemia (57%), diabetes (51%), obesity (30%), a previous history of stroke (24%) and coronary artery disease (23%). The combination of hypertension, diabetes and dyslipidemia was most common in the third of patients with three concomitant risk factors. ...
... In one case-control study in Qatar, the strongest risk factor identified for diabetes was Qatari nationality, yielding an odds ratio (95% confidence intervals) of 5.5 (3.5-8.6) after adjustment for all other measured factors. 62 Among the findings reported by Deleu et al. 27 was that Arab stroke patients tended to be older than South Asian patients (65 years vs 53 years, P ¼ 0.0001) despite having a higher average BMI (33 vs 28 kg/m 2 , P ¼ 0.002), more often presenting with diabetes (64% vs 46%, P ¼ 0.004) and a greater number of concomitant risk factors (3.0 vs 2.6, P ¼ 0.005). 27 This is corroborated by our observation of stroke of later onset even with a greater prevalence of most major risk factors among native Qataris than South Asians within BRAINS, as has similarly been reported by Akhtar et al. 39 Ventricular wall motion abnormalities and carotid artery stenotic lesions were also significantly more prevalent among Arab patients. ...
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... A recent study of 672 stroke patients showed evidence of high-grade stenosis (70%-99%) in 12% patients 18. Similarly studies have shown anterior circulation infarct to be the most common followed by lacunar infract which was similar to the study done in Indo-American stroke patients in New Jersey America 11,13 . However a few other studies from India and Pakistan also showed that lacunar strokes are the predominant stroke subtype 19,20,21,22 . ...
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Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.
... Factors associated with stroke recurrence may differ than those associated with first stroke, but there are limited data assessing stroke recurrence specifically among South Asians. Among 189 non-cardioembolic ischemic stroke patients in Qatar, 32% of whom were of South Asian descent, there was a 10% stroke recurrence within up to 2 to 4 years of follow-up [10]. Among 874 stroke patients studied as part of a cross-sectional multiple hospital-based registry in Pakistan, 18.4% had a previous stroke [8]. ...
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... Twenty-seven included studies have a retrospective design 10,11,17,20,23,27,37,[39][40][41]45,47,[51][52][53][54][55]57,[63][64][65][66][67][68][69]72,73 compared to 16 having a prospective study design. 13,19,21,22,26,30,34,35,38,42,44,46,49,50,60,70 Two studies have both, a retrospective and a prospective design. ...
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... A retrospective study performed at HGH by Hamad et al., 13 covering the period between January and December 1997, revealed the following as major risks for stroke: hypertension (63%), diabetes mellitus (42%), ischemic heart disease (17%), and atrial fibrillation (4.5%). Another retrospective study (n = 303) conducted by Deleu et al. 18 at HGH, between January and December 2001, on ethnic variations in risk factor profile, pattern, and recurrence of noncardioembolic ischemic stroke revealed that hypertension (69%) was the most commonly encountered risk factor followed by dyslipidemia (57%), diabetes mellitus (51%), and obesity (30%). The majority of strokes were lacunar hemispheric strokes (68%), followed by lacunar brainstem strokes (15%) and largevessel hemispheric infarctions (10%). ...
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... The available data on strokes and the associated risk factors in the GCC were derived mostly from retrospective hospital-based studies but no population-based studies. The data on strokes and associated risk factors was reported in 12 studies: 4 in Saudi Arabia [15][16][17][18], 1 in Bahrain [19], 3 in Kuwait [20][21][22], 3 in Qatar [23][24][25], and 1 from multiple GCC countries [26]. ...
... was the most common risk factor, followed by diabetes (20-69.4%) for stroke patients [15,[17][18][19][20][21][22][23][24][25][26]. Dyslipidemia was reported in 4-61% of stroke patients [18][19][20][21][22][23][24]26]. ...
... for stroke patients [15,[17][18][19][20][21][22][23][24][25][26]. Dyslipidemia was reported in 4-61% of stroke patients [18][19][20][21][22][23][24]26]. Smoking was reported in 1.6-40% of stroke patients in the GCC [15,[17][18][19][20][21][22][23][24]26]. ...
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Background. CVD is a principal cause of mortality and disability globally. Objective. To analyse the epidemiological data on CHD, strokes, and the associated risk factors among adult population in the Gulf countries. Methods. A systematic review of published articles between 1990 and 2014 was conducted. Results. The analysis included 62 relevant studies. The prevalence of CHD was reported to be 5.5% in Saudi Arabia. The annual incidence of strokes ranged from 27.6 to 57 per 100 000 in the Gulf countries with ischaemic stroke being the most common subtype and hypertension and diabetes being the most common risk factors among stroke and ACS patients. The prevalence of overweight and obesity ranged from 31.2% to 43.3% and 22% to 34.1% in males and from 28% to 34.3% and 26.1% to 44% in females, respectively. In males, the prevalence of hypertension and diabetes ranged from 26.0% to 50.7% and 9.3% to 46.8%, respectively; in females these ranged from 20.9% to 57.2% and 6% to 53.2%, respectively. The prevalence of inactivity was from 24.3% to 93.9% and 56.7% to 98.1% in males and females, respectively. Relatively more males (13.4% to 37.4%) than females (0.5% to 20.7%) were current smokers. Available data indicate poor dietary habits with high consumption of snacks, fatty foods, sugar, and fast food. Conclusion. Effective preventative strategies and education programs are crucial in the Gulf region to reduce the risk of CVD mortality and morbidity in the coming years.
... 102 Finally a study in Qatar of patients with ischemic stroke, 32% of whom were South Asian showed that diabetes was present in 46.4% of South Asians. 103 South Asians experience increased mortality from stroke compared to Europeans which also has been associated with diabetes. 100,104 Results of the West Birmingham Stroke Project found that mortality in migrant South Asians with ischemic stroke was associated with diabetes. ...
Article
The rising prevalence of diabetes in South Asians has significant health and economic implications. South Asians are predisposed to the development of diabetes due to biologic causes which are exacerbated by lifestyle and environmental factors. Furthermore, they experience significant morbidity and mortality from complications of diabetes, most notably coronary artery disease, cerebrovascular disease, and chronic kidney disease. Therefore, understanding the pathophysiology and genetics of diabetes risk factors and its associated complications in South Asians is paramount to curbing the diabetes epidemic. With this understanding, the appropriate screening, preventative and therapeutic strategies can be implemented and further developed. In this review, we discuss in detail the biologic and lifestyle factors that predispose South Asians to diabetes and review the epidemiology and pathophysiology of microvascular and macrovascular complications of diabetes in South Asians. We also review the ongoing and completed diabetes prevention and management studies in South Asians.
... Among the 37 studies indicating the stroke ratio male to female, the majority (29) found stroke to be more prevalent among men than women with ratios varying from 1.3:1 to 2:1 in 14 studies [18,19,29,34,[38][39][40][41]43,[46][47][48]56,60], from 2:1 to 3:1 in seven studies [21,45,[51][52][53]57,58] and from 3:1 to 3.55:1 in 2 studies [44,59]. As stressed by one of the authors [51], the high male to female ratios found in studies from Qatar (2.6:1, 2.7:1) and from Saudi Arabia (1.7:1,2.1:1,2.2:1,3.4:1) ...
... The quasi-totality of studies reported that stroke risk increases with aging. Twenty six studies indicated a mean age in the sixth decade [18,20,21,[23][24][25][26][27][28][29][30]33,37,38,42,45,[47][48][49][50][51][52]54,57,59,60], eight studies found a mean age between 56 and 59 years [19,34,[39][40][41]46,53,58], and only two studies reported a mean age of 41.4 years [44] and 50 years [43]. ...
... The prevalence of hypertension was equal to or greater than 75% in nine studies [20,22,37,[45][46][47][48]60,62], between 50% and 75% in 29 studies [18,19,[23][24][25][26][27][30][31][32][33][34][35][36][38][39][40][41][42][43][44][49][50][51][52][53][57][58][59], between 25% and 50% in six studies [21,28,29,55,56,61] and only one study reported a prevalence of hypertension less than 25% (24.9%) [54]. ...