Community Based Study of Cerebrovascular Risk Factors in Tripoli-Libya (North Africa)

Abstract

A stroke is the leading cause of adult mortality and disability. It is the second most common cause of death globally and may soon become the first cause of death worldwide. Among the most important risk factors for stroke are advanced age, hypertension, diabetes, previous stroke or transient ischemic attack. Hypertension and diabetes are the most important and frequent modifiable risk factors of stroke. Objectives: Estimate the most important risk factors associated with stroke in African population by using CHADS2 method. Study Design: Was community based descriptive cross-section. Place and Duration of Study: North Africa (North west of Libya), among Individuals living in Tripoli area the capital, Duration of the study, five years from 1/1/2010 in to 31/12/2014. Methodology: Data collected among 7497 individuals do not have atrial fibrillation (52.8% males & 48.2% females) which contained detailed histories (present, past, medical, hospital admission), available investigations, discharge letters and medical reports. Medical examinations was performed when necessary. Results: Among population screened (7497) over five years (from 2010 to 2014), the prevalence of diabetes was 39%, it was more among males than females (P=0.001). Hypertension was 38%, for most of age groups males have higher rate than females (P=0.041). Diabetes and hypertension increases with age groups over 40 (P<0.0001). Congestive heart failure was 15.2% which increased with age (P<0.0001). Females have higher prevalence for 16-59 age groups and males dominated in over 60 years. Transient ischemic attack (TIA) was 15%, males have higher TIA than females in all age groups (P <0.001) and increases with age (P<0.0001). Prior Stroke (ischemic or hemorrhagic) prevalence was 9.7%, it was more among males than females (P=0.05) and increases with age over 40 (P<0.0001). Conclusion: This Libyan study found stroke is a major public health problem in Africa, prevalence of stroke increases with age, and males are affected more than females for most of age groups. Diabetes, Hypertension, Congestive heart failure and previous history of embolic or transient ischemic attack are major risk factors that are associated with stroke. Recommendation: To do another studies to measures stroke risk factors by using laboratory investigations, and other medical diagnostic procedures, consequently, to estimate the most accurate and true rates.