Stroke risk increased in poorer countries

Sposato LA. Stroke. 2011;doi:10.1161/?STROKEAHA.111.632158.

Issue: December 2011

Lower macro-socioeconomic status was associated with poorer stroke-related outcomes in a recent study.

A multinational group of researchers aimed to analyze the relationship between clinical outcomes and three widely used measures of macro-socioeconomic status: per capita gross domestic product adjusted for purchasing power parity; total health expenditures per capita at purchasing power parity; and unemployment rate. Twenty-three articles comprising 30 studies were evaluated in the final analysis.

Eligible studies were population-based and reported incident stroke risk and/or 30-day case-fatality rates according to criteria prespecified by the researchers. Comparisons were drawn between each of the three macro-socioeconomic status indicators and risk for stroke, 30-day case-fatality, proportion of hemorrhagic strokes and age at stroke onset.

Age-adjusted incident risk for stroke using the standardized WHO world population was linked to lower per capita GDP adjusted for purchasing power parity (P=.027) and total health expenditures per capita at purchasing power parity (P=.040), according to the results.

Lower per capita GDP adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity was linked to both 30-day case-fatality ratio and proportion of hemorrhagic strokes.

Populations with low per capita GDP adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity experienced strokes at a younger age.

The indicators used for this study “may be used as proxy measures of quality of primary prevention and acute care and considered as important factors for developing strategies aimed at improving worldwide stroke care,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

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