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Titolo:
Prevention of stroke in urban China - A community-based intervention trial
Autore:
Fang, XH; Kronmal, RA; Li, SC; Longstreth, WT; Cheng, XM; Wang, WZ; Wu, SP; Du, XL; Siscovick, D;
Indirizzi:
BeijingaNeurosurg Inst, Dept Neuroepidemiol, Beijing 100050, Peoples R Chin Beijing Neurosurg Inst Beijing Peoples R China 100050 50, Peoples R Chin Univ Washington, Dept Biostat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Dept Biostat, Seattle, WA 98195 USA Univ Washington, Dept Neurol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 , Dept Neurol, Seattle, WA 98195 USA Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Epidemiol, Seattle, WA 98195 USA Univ Washington, Dept Med, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ton, Dept Med, Seattle, WA 98195 USA Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA
Titolo Testata:
STROKE
fascicolo: 3, volume: 30, anno: 1999,
pagine: 495 - 501
SICI:
0039-2499(199903)30:3<495:POSIUC>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; REPUBLIC-OF-CHINA; BLOOD-PRESSURE; RISK-FACTORS; HYPERTENSION;
Keywords:
China; risk factors; stroke prevention;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Fang, XH BeijingaNeurosurg Inst, Dept Neuroepidemiol, Beijing 100050, Peoples R Chin Beijing Neurosurg Inst Beijing Peoples R China 100050 es R Chin
Citazione:
X.H. Fang et al., "Prevention of stroke in urban China - A community-based intervention trial", STROKE, 30(3), 1999, pp. 495-501

Abstract

Background and Purpose-Stroke has been the second leading cause of death in large cities in China since the 1980s. Meanwhile, the prevalences of hypertension and smoking have steadily increased over the last 2 decades. Therefore, a community-based intervention trial was initiated in 7 Chinese cities in 1987. The overall goal of the study was to evaluate the effectiveness of an intervention aimed at reducing multiple risk factors for stroke. The primary study objective was to reduce the incidence of stroke by 25% over 3.5 years of intervention. Methods-In May 1987 in each of 7 the cities, 2 geographically separated communities with a registered population of about 10 000 each were selected as either intervention or control communities. In each community,a cohort containing about 2700 subjects (greater than or equal to 35 years old) free of stroke was sampled, and a survey was administered to obtain baseline dataand screen the eligible subjects for intervention. In each city, a programof treatment for hypertension, heart disease, and diabetes was instituted in the intervention cohort (n approximate to 2700) and health education wasprovided to the full intervention community (n approximate to 10 000), A follow-up survey was conducted in 1990. Comparisons of intervention and control cohorts in each city were pooled to yield a single summary. Results-A total of 18 786 subjects were recruited to the intervention cohort and 18 876 to the control cohort from 7 cities. After 3.5 years, 174 newstroke cases had occurred in the intervention cohort and 253 in the control cohort. The 3.5-year cumulative incidence of total stroke was significantly lower in the intervention cohort than the control cohort (0.93% versus 1.34%; RR=0.69; 95% CI, 0.57 to 0.84). The incidence rates of nonfatal and fatal stroke, as well as ischemic and hemorrhagic stroke, were significantlylower in the intervention cohort than the control cohort. The prevalence of hypertension increased by 4.3% in the intervention cohort and by 7.8% in the control cohort. The average systolic and diastolic blood pressures increased more in the control cohort than in the intervention cohort. Among hypertensive individuals in the intervention cohort, awareness of hypertensionincreased by 6.7% and the percentage of hypertensives who regularly took antihypertensive medication increased 13.2%. All of these indices became worse in the control cohort. The prevalence of heart diseases and diabetes increased significantly in the both cohorts (P<0.01). The prevalence of consumption of alcohol increased slightly, and that of smoking remained constant in both cohorts. Conclusions-A community-based intervention for stroke reduction is feasible and effective in the cities of China. The reduction, due to the intervention, in the incidence of stroke in the intervention cohort was statistically significant after 3.5 years of intervention. The sharp reduction in the incidence of stroke may be due to the interventions having blunted the expected increase in hypertension that accompanies aging as well as to better and earlier treatment of hypertension, particularly borderline hypertension. Applied health education to all the residents of the community may have prevented some normotensive individuals from developing hypertension and improved overall health awareness and knowledge.

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Documento generato il 29/11/20 alle ore 06:01:17