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INTRODUCTION: Cerebrovascular disease (CVD) is the third cause of death and second cause of disability and dementia in adults aged =65 years worldwide. The few epidemiological studies of stroke in Latin America generally report lower prevalence and different patterns than developed countries. OBJECTIVE: Estimate the prevalence of stroke and associated risk factors in adults aged ⩾65 years in Havana City and Matanzas provinces, Cuba. METHODS: Single phase, cross-sectional, door-to-door study of 3015 adults aged ⩾65 years in selected municipalities of Havana City and Matanzas provinces. Variables studied were age, sex, educational level, and self-report and description of chronic disease (stroke, heart attack, angina, and diabetes mellitus), substance use (alcohol, tobacco), and dietary habits. Respondents were given a structured physical and neurological exam, and blood pressure was measured. Laboratory tests comprised complete blood count, fasting glucose, total cholesterol and fractions, triglycerides, and apolipoprotein E (APOE) genotype. Diagnosis of stroke was based on the World Health Organization's defi nition. Stroke prevalence ratios (crude and adjusted), with 95% confi dence intervals (CI), were calculated for the variables studied using a Poisson regression model. Risk association was analyzed using multiple logistic regression for dichotomous responses. RESULTS: Assessments were made of 2944 older adults (97.6% response rate). Prevalence of stroke was 7.8% (95% CI 6.9-8.8), and was higher in men. The risk profi le for this population group included history of hypertension (OR 2.8; 95% CI 2.0-4.0), low HDL cholesterol (OR 2.6; 95% CI 1.7-3.9), male sex (OR 1.7; 95% CI 1.2-2.5), anemia (OR 1.6; 95% CI 1.1-2.5), history of ischemic heart disease (OR 1.5; 95% CI 1.0-2.3), carrier of one or two apolipoprotein E4 genotype (APOE ϵ4) alleles (OR 1.4; 95% CI 1.0-2.0), and advanced age (OR 1.3; 95% CI 1.1-1.9). CONCLUSIONS: Stroke prevalence in this study is similar to that reported for Europe and North America, and higher than that observed in other Latin American countries. The risk profi le identifi ed includes classic risk factors plus anemia and APOE e4 genotype. [ABSTRACT FROM AUTHOR]

Introduction: Cerebrovascular disease is the third-leading cause of death and the second-leading cause of disability and dementia., Objective: Determine stroke incidence and risk factors in a population of adults aged 65 and over in Cuba (Havana and Matanzas)., Material and Methods: This prospective longitudinal study, completed between April 2008 and Abril 2011, re-evaluated 2916 elderly adults with an average follow-up time of 4 years. Cases included 2316 living subjects and 600 verbal autopsies. Study variables were age, sex, educational level, self-reported health, and description of chronic diseases and substance abuse. Laboratory tests included genotyping APOE. Stroke was diagnosed based on the World Health Organization definition. We calculated the global incidence rate for stroke, broken down by sex, age group, and risk factors for incident stroke., Results: Stroke incidence was 786.2 in 100000 persons/year (95% CI: 672.3-906.4). History of alcohol consumption (HR: 3.5; 95% CI: 3.3-3.7), dementia (HR: 3.0; 95% CI, 1.6-5.5) and male sex (HR: 1.8; 95% CI, 1.2-2.8) were shown to be risk factors for incident stroke., Conclusions: Stroke incidence was similar to rates reported in developed countries and lower than that in low- to middle-income countries. Given that diabetes mellitus, heart disease, arterial hypertension, smoking, APOE4, etc. are associated with higher mortality rates, they will require separate analysis in a study of stroke risk factors., (Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.)

The authors compared Apo-E epsilon 4 frequencies for Cuban American and white non-Hispanic persons with and without Alzheimer's disease (AD). The Apo-E epsilon 4 allele conferred as large a risk for AD in Cuban Americans as for white non-Hispanics, a finding that differs from those for Hispanic subjects as a whole.