Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project).
Identifieur interne : 000074 ( Main/Exploration ); précédent : 000073; suivant : 000075Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project).
Auteurs : Oscar H. Del Brutto [Équateur] ; Robertino M. Mera [États-Unis] ; Mauricio Zambrano [Équateur] ; Victor J. Del Brutto [États-Unis]Source :
- International journal of stroke : official journal of the International Stroke Society [ 1747-4949 ] ; 2017.
Descripteurs français
- KwdFr :
- Accident vasculaire cérébral (), Accident vasculaire cérébral (épidémiologie), Adulte, Adulte d'âge moyen, Bouche édentée (), Bouche édentée (épidémiologie), Comorbidité, Facteurs de risque, Femelle, Humains, Hypertension artérielle (), Hypertension artérielle (épidémiologie), Incidence, Indice de gravité médicale, Mâle, Population rurale, Équateur (épidémiologie), Études de suivi, Études prospectives.
- MESH :
- épidémiologie : Accident vasculaire cérébral, Bouche édentée, Hypertension artérielle, Équateur.
- Accident vasculaire cérébral, Adulte, Adulte d'âge moyen, Bouche édentée, Comorbidité, Facteurs de risque, Femelle, Humains, Hypertension artérielle, Incidence, Indice de gravité médicale, Mâle, Population rurale, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Adult, Comorbidity, Ecuador (epidemiology), Female, Follow-Up Studies, Humans, Hypertension (complications), Hypertension (epidemiology), Incidence, Male, Middle Aged, Mouth, Edentulous (complications), Mouth, Edentulous (epidemiology), Prospective Studies, Risk Factors, Rural Population, Severity of Illness Index, Stroke (complications), Stroke (epidemiology).
- MESH :
- complications : Hypertension, Mouth, Edentulous, Stroke.
- epidemiology : Ecuador, Hypertension, Mouth, Edentulous, Stroke.
- Adult, Comorbidity, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors, Rural Population, Severity of Illness Index.
Abstract
Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged ≥40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 ± 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged ≥57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings.
DOI: 10.1177/1747493016676621
PubMed: 27777377
Affiliations:
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Del Brutto</name><affiliation wicri:level="1"><nlm:affiliation>1 School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador.</nlm:affiliation><country xml:lang="fr">Équateur</country><wicri:regionArea>1 School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil</wicri:regionArea><wicri:noRegion>Guayaquil</wicri:noRegion></affiliation></author><author><name sortKey="Mera, Robertino M" sort="Mera, Robertino M" uniqKey="Mera R" first="Robertino M" last="Mera">Robertino M. Mera</name><affiliation wicri:level="1"><nlm:affiliation>2 Medical Center, University of Vanderbilt, Nashville, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>2 Medical Center, University of Vanderbilt, Nashville, TN</wicri:regionArea><wicri:noRegion>TN</wicri:noRegion></affiliation></author><author><name sortKey="Zambrano, Mauricio" sort="Zambrano, Mauricio" uniqKey="Zambrano M" first="Mauricio" last="Zambrano">Mauricio Zambrano</name><affiliation wicri:level="1"><nlm:affiliation>3 Community Center, The Atahualpa Project, Atahualpa, Ecuador.</nlm:affiliation><country xml:lang="fr">Équateur</country><wicri:regionArea>3 Community Center, The Atahualpa Project, Atahualpa</wicri:regionArea><wicri:noRegion>Atahualpa</wicri:noRegion></affiliation></author><author><name sortKey="Del Brutto, Victor J" sort="Del Brutto, Victor J" uniqKey="Del Brutto V" first="Victor J" last="Del Brutto">Victor J. Del Brutto</name><affiliation wicri:level="1"><nlm:affiliation>4 Department of Neurology, University of Chicago, Chicago, IL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>4 Department of Neurology, University of Chicago, Chicago, IL</wicri:regionArea><wicri:noRegion>IL</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of stroke : official journal of the International Stroke Society</title><idno type="eISSN">1747-4949</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Comorbidity</term><term>Ecuador (epidemiology)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hypertension (complications)</term><term>Hypertension (epidemiology)</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Mouth, Edentulous (complications)</term><term>Mouth, Edentulous (epidemiology)</term><term>Prospective Studies</term><term>Risk Factors</term><term>Rural Population</term><term>Severity of Illness Index</term><term>Stroke (complications)</term><term>Stroke (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral ()</term><term>Accident vasculaire cérébral (épidémiologie)</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bouche édentée ()</term><term>Bouche édentée (épidémiologie)</term><term>Comorbidité</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hypertension artérielle ()</term><term>Hypertension artérielle (épidémiologie)</term><term>Incidence</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Population rurale</term><term>Équateur (épidémiologie)</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Hypertension</term><term>Mouth, Edentulous</term><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Ecuador</term><term>Hypertension</term><term>Mouth, Edentulous</term><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Accident vasculaire cérébral</term><term>Bouche édentée</term><term>Hypertension artérielle</term><term>Équateur</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Comorbidity</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Risk Factors</term><term>Rural Population</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Accident vasculaire cérébral</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bouche édentée</term><term>Comorbidité</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hypertension artérielle</term><term>Incidence</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Population rurale</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged ≥40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 ± 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged ≥57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings.</div></front></TEI><affiliations><list><country><li>Équateur</li><li>États-Unis</li></country></list><tree><country name="Équateur"><noRegion><name sortKey="Del Brutto, Oscar H" sort="Del Brutto, Oscar H" uniqKey="Del Brutto O" first="Oscar H" last="Del Brutto">Oscar H. Del Brutto</name></noRegion><name sortKey="Zambrano, Mauricio" sort="Zambrano, Mauricio" uniqKey="Zambrano M" first="Mauricio" last="Zambrano">Mauricio Zambrano</name></country><country name="États-Unis"><noRegion><name sortKey="Mera, Robertino M" sort="Mera, Robertino M" uniqKey="Mera R" first="Robertino M" last="Mera">Robertino M. Mera</name></noRegion><name sortKey="Del Brutto, Victor J" sort="Del Brutto, Victor J" uniqKey="Del Brutto V" first="Victor J" last="Del Brutto">Victor J. Del Brutto</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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