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Purpose: To assess associations between atrial fibrillation/atrial flutter (AF) and ocular parameters and diseases. Methods: The population‐based Ural Eye and Medical Study (UEMS) and the Ural Very Old Study (UVOS) included 4894 individuals (age: 40+ years) and 835 individuals (age: 85+ years), respectively. Results: In the UEMS, AF prevalence (80/4894; 1.6%; 95% CI: 1.3, 2.0) increased from 1/1029 (0.1%) in the age group of 40 to <50 years to 29/619 (4.7%) and 12/159 (7.5%) in the age groups of 70 to <80 years and 80+ years, respectively. Higher AF prevalence correlated with older age (OR: 1.08; 95% CI: 1.04, 1.12; p < 0.001), urban region of habitation (OR: 1.08; 95% CI: 1.04, 1.12; p < 0.001), higher prevalence of cardiovascular disease/stroke (OR: 2.50; 95% CI: 1.32, 4.72; p < 0.001) and lower prevalence of neck pain (OR: 0.35; 95% CI: 0.14, 0.85; p = 0.02), higher serum concentration of bilirubin (OR: 1.03; 95% CI: 1.02, 1.05; p < 0.001) and lower prothrombin index (OR: 0.96; 95% CI: 0.93, 0.99; p = 0.003), higher stage of arterial hypertension (OR: 1.52; 95% CI: 1.01, 2.28; p = 0.04) and higher ankle‐brachial index (OR: 22.1; 95% CI: 4.45, 1.10; p < 0.001). In that model, AF prevalence was not associated with ocular parameters such as intraocular pressure (p = 0.52), retinal nerve fibre layer thickness (p = 0.70), refractive error (p = 0.13), axial length (p = 0.14), nuclear cataract degree (p = 0.50) and prevalence (p = 0.40), cortical cataract degree (p = 0.43) and presence (p = 0.17), lens pseudoexfoliation (p = 0.58), status after cataract surgery (p = 0.38), age‐related macular degeneration prevalence (p = 0.63), open‐angle glaucoma presence (p = 0.90) and stage (p = 0.55), angle‐closure glaucoma prevalence (p = 0.99) and stage (p = 0.99), diabetic retinopathy prevalence presence (p = 0.37) and stage (p = 0.32), and myopic macular degeneration (p = 0.98). In the UVOS, similar results were obtained. Conclusions: In these multi‐ethnic populations from Russia, AF prevalence was not associated with any major ocular disease and may not play a major role in the pathogenesis of these disorders. [ABSTRACT FROM AUTHOR]

As stroke mortality rates according to race were not known in Brazil, data on mortality for the year 2010 was collected from the Mortality Information System of the Brazilian Ministry of Health. Cerebrovascular mortality rates adjusted for age (per 100,000) were calculated with a confidence interval of 95% (95%CI) by sex and race/skin color. The differences between races were significant for men with rates of 44.4 (43.5;45.3), 48.2 (47.1;49.3) and 63.3 (60.6;66.6) for white, brown and black, respectively; and for women, with rates of 29.0 (28.3;29.7), 33.7 (32.8;34.6) and 51.0 (48.6;53.4) for white, brown and black, respectively. The burden of stroke mortality is higher among blacks compared to brown and white. [ABSTRACT FROM AUTHOR]

Background: Stroke is the second leading cause of death in Korea but long-term survival of Korean stroke patients has not been studied. Thus, we examined 6-year survival and causes of death in a nationally representative inpatient sample. Methods: Between January 2000 and March 2000 in 152 sample hospitals, 4,299 first-ever stroke patients were identified and followed-up for vital status until December 2005. Mortality and mortality-related factors were evaluated by the Kaplan-Meier method and Cox proportional hazard regression analysis. Results: Ischemic stroke was the most common subtype (62.9%), followed by intracerebral hemorrhage (ICH, 21.2%), and subarachnoid hemorrhage (SAH, 6.4%). Six-year mortality was estimated at 37.1% for all strokes, 37.2% for ischemic, 41.0% for ICH, and 29.2% for SAH. Common causes of death were stroke (58.2%), malignancies (10.3%), other cardiovascular diseases (7.7%), and diabetes (6.8%). Six-year mortality was associated with old age (hazard ratio 1.70 per 10 years, 95% CI 1.62–1.78), male sex (1.29, 1.16–1.43), subtypes of ICH (1.30, 1.15–1.48) and SAH (1.43, 1.14–1.80), longer hospital admission (1.01 per 10 days, 1.00–1.03), and loss of consciousness (1.32, 1.13–1.55). Conclusions: More than 60% of Korean patients with first-ever stroke survived to 6 years. Major causes of death were stroke, cancer, cardiovascular diseases, and diabetes. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Prospective stroke registries allow analyzing important aspects of the natural history of acute cerebrovascular events. Using the Sagrat Cor Hospital of Barcelona Stroke Registry, we aimed to determine trends in risk factors, stroke subtypes, prognosis and in-hospital mortality over 19 years in hospitalized stroke patients. Methods: The study population consisted of 2,416 first-ever stroke patients (ischemic stroke, n = 2,028; intracerebral hemorrhage, n = 334) included in the stroke registry up to December 31, 2004. Temporal trends in stroke patient characteristics for the periods 1986–1992, 1993–1998 and 1999–2004 were assessed. Results: Age was significantly different among the analyzed periods (p < 0.001), showing an increment in older patients throughout time. Hypertension (p = 0.001), diabetes (p = 0.004), ischemic heart disease (p = 0.002) and atrial fibrillation increased (p = 0.000) as opposed to heavy smoking (p = 0.000) and history of TIA (p = 0.025). The mortality rate and the length of hospital stay decreased (p = 0.001), whereas transfer to convalescent/rehabilitation units increased (p = 0.001). Conclusions: An improvement in acute-stroke management and possibly evolution of cerebrovascular risk factors is reflected by changes in the risk factors and outcome of first-ever stroke patients admitted to a stroke unit over a 19-year time span. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were (1) to establish a prospective community-based stroke registry in Mumbai of subjects having ‘first-ever stroke’ (FES) and (2) to collect standardized data on annual incidence, stroke subtypes, and case fatality rate at 28 days during the years 2005 and 2006. Background: An estimated 5.8 million people died from stroke (cerebrovascular disease) in 2005, two thirds of them were from low-/middle-income countries but reliable population-based studies are scarce. Methods: The manual on WHO STEPwise approach to stroke surveillance (STEPS Stroke; http://www.who.int/chp/steps/Manual pdf) was the operational protocol. We selected a well-defined community (H-district) having verifiable census data and being representative of the population structure of Mumbai (Bombay). Of 337,391 permanent residents, 156,861 persons between the age of 25 and 94+ years who were eligible for survey were screened. The responses to a predefined questionnaire (version 2.0) were entered in coded data sheets for analysis. Results: During the 2-year study period (January 2005 to December 2006), 456 (238 males and 218 females) had FES, indicating an annual incidence in subjects of 25 years and above of 145/100,000 persons (CI 95%: 120–170); for males it is 149/100,000 persons (CI 95%: 120–170) and for females it is 141/100,000 persons (CI 95%: 120–160). The age-standardized rate for study population (both sexes) by the direct method using Segi’s 1996 world population is 152/100,000/year (CI 95%: 132–172). Stroke diagnosis was supported by computed tomography in 407 (89.2%) of 456 FES cases: 366 (80.2%) had ischemic stroke, 81 (17.7%) had hemorrhagic stroke and 9 (1.9%) were in the unspecified category. The mean age was 66 ± (SD) 13.60 years, women were older as compared to men (mean age 68.9 ± 13.12 years vs. 63.4 ± 13.53 years). Case fatality: at 28 days, 320 (70%) of 456 FES cases were still alive and 136 (29.8%) had died. Of the 320 surviving patients 38.5% had moderate to severe disability by the modified Rankin scale. Conclusions: The results of Mumbai stroke study, using uniform definitions and methodologies, show that the annual standardized incidence rates, stroke subtypes and case fatality rate are very similar to those reported from developed nations. To plan effective intervention and prevention strategies, standardized data in representative samples of regional populations are urgently needed. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Our aim was to assess prevalence rates of cerebrovascular disease (CVD; stroke and transient ischemic attacks) according to age and gender in three populations in central Spain using data from the Neurological Disorders in Central Spain (NEDICES) study, a population-based survey of elderly participants. Methods: Individuals from one suburban municipality of Greater Madrid (Las Margaritas neighborhood, Getafe), one urban district of Madrid (Lista) and one rural site (Arévalo county, Avila) were evaluated at baseline (n = 5,278). The evaluation included a screening questionnaire and a neurological assessment when possible. We used point prevalence with a reference date of May 1, 1994. Results: Of the 5,278 subjects, there were 186 prevalent stroke cases and 71 cases of transient ischemic attacks. Prevalence rates, adjusted to the standard European populations, were 4.9% for CVD (95% confidence interval [CI] = 4.3–5.4), 3.4% for stroke (95% CI = 2.9–3.9) and 1.3% for transient ischemic attacks (95% CI = 1.0–1.6) in the total population. Age-specific prevalence rates of CVD, stroke and transient ischemic attacks increased exponentially with advancing age. The prevalence rates of CVD, stroke and transient ischemic attacks were higher for men than for women. Prevalence figures were higher in the suburban area of Margaritas compared to the rural region. Conclusions: In this study, the prevalence of stroke and transient ischemic attacks were higher in men and in urban areas. Central Spain would be a medium stroke prevalence zone. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Several studies have shown a relationship between low socioeconomic status, age and stroke mortality. However, there is lack of similar studies in relation to stroke incidence. All cases of first-ever stroke occurring in a population aged 35–85 years from the city of Umeå were collected from hospital-based registers during a 2-year study period (2000–2002), from death certificates and also from nursing homes during a 6-month period. The WHO definition of stroke was used. Register data served to analyze educational level. A total of 457 first-ever strokes (244 women and 213 men) were registered, corresponding to an overall annual incidence rate of first-ever stroke of 413.4 per 100,000. The incidence of first-ever stroke was significantly higher among low-educated compared to high-educated men and women. The highest stroke incidence was found among low-educated women aged 75–85 years. The educational-related differences in stroke incidence persisted in the oldest age group (75–85 years), also after controlling for sex and age. This is one of the first studies that analyzes first-ever stroke incidence also among elderly men and women (75–85 years) in relation to socioeconomic status. More community-based studies are needed in order to confirm the results. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: There is uncertainty regarding the impact of changes in stroke care and natural history of stroke in the community. We examined factors responsible for trends in survival after stroke in a series of population-based studies. Methods: We used statistical models to assess temporal trends in 28-day and 1-year case fatality after first-ever stroke cases registered in 3 stroke incidence studies undertaken in Auckland, New Zealand, over uniform 12-month calendar periods in 1981–1982 (n = 1,030), 1991–1992 (1,305) and 2001–2002 (1,423). Cox proportional hazards regression was used to evaluate the significance of pre-defined ‘patient’, ‘disease’ and ‘service/care’ factors on these trends. Results: Overall, there was a 40% decline in 28-day case fatality after stroke over the study periods, from 32% (95% confidence interval, 29–35%) in 1981–1982 to 23% (21–25%) in 1991–1992 and then 19% (17–21%) in 2002–2003. Similar relative declines were seen in 1-year case fatality. In regression models, the trends were still significant after adjusting for patient and disease factors. However, further adjustment for care factors (higher hospital admission and neuroimaging) explained most of the improvement in survival. Conclusions: These data show significant downwards trends in case fatality after stroke in Auckland over 20 years, which can largely be attributed to improved stroke care associated with increases in hospital admission and brain imaging during the acute phase of the illness. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Stroke is the third leading cause of death, after cardiac disease and cancer, in most industrialised countries. Moreover, stroke is an important cause of long term disability and is the most common life-threatening neurological disease. During past years, there has been a declining trend in stroke incidence, mortality and case-fatality; the reasons for this are unclear and there is no evidence of the persistence of this favourable trend since 1980. The improved knowledge and, consequently, improved management of stroke risk factors and new trends in acute stroke treatment seem to account for this evolution. We present a review of stroke epidemiology, aetiology and emergency clinical and diagnostic aspects, paying particular attention to ischaemic strokes, which have been the subject of most of the research and clinical trials carried out in recent years. Moreover, we propose a brief guideline for diagnosis of stroke in the acute phase. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective There is gap in knowledge about obesity prevalence in stroke patients from low- and middle-income countries. Therefore, we aimed to measure the prevalence of overweight and obesity status among patients with incident stroke in Brazil. Methods In a cross-sectional study, we measured the body mass index (BMI) of ischemic and hemorrhagic stroke patients. The sample was extracted in 2016, from the cities of Sobral (CE), Sertãozinho (SP), Campo Grande (MS), Joinville (SC) and Canoas (RS). Results In 1,255 patients with first-ever strokes, 64% (95% CI, 62–67) were overweight and 26% (95%CI, 24–29) were obese. The obesity prevalence ranged from 15% (95%CI, 9–23) in Sobral to 31% (95%CI, 18–45) in Sertãozinho. Physical inactivity ranged from 53% (95%CI, 43-63) in Sobral to 80% (95%CI, 73–85) in Canoas. Conclusions The number of overweight patients with incident stroke is higher than the number of patients with stroke and normal BMI. Although similar to other findings in high-income countries, we urgently need better policies for obesity prevention.