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Abstract
Background and objectives The epidemiology of stroke at high altitudes has not been extensively studied, especially at heights of 4000 m and above. Thus, stroke prevention and treatment at high altitudes are challenging. We conducted a cross-sectional study to estimate the prevalence of stroke, the detection rate of individuals at high risk of stroke and the risk factors for stroke in the Qinghai-Tibet Plateau in China, a high altitude plateau that inhabits approximately 15 million people.
Design A population-based cross-sectional study in the Qinghai-Tibet Plateau.
Setting Data were collected from participants through face-to-face screening using a primary screening table. The table relied on the China National Stroke Screening and Prevention Project.
Participants A total of 10 700 residents aged ≥40 years and living on the Qinghai-Tibet Plateau for more than 6 months participated from January 2019 to December 2021.
Main outcome measures The primary screening table included basic demographic information, medical history information, personal lifestyle habits and physical examination information.
Results A total of 10 056 people were included in the analysis. The prevalence of stroke was 2.3% (95% CI 2.0% to 2.6%), and the detection rate of individuals at high risk of stroke was 26.2% (95% CI 25.3% to 27.0%). The prevalence of stroke and the detection rate of individuals at high risk of stroke increased with altitude (p<0.01), and the prevalence of stroke at high altitudes was almost 2.2 times that at mid-altitudes (p<0.01). After full adjustments, age, residence, hypertension, family history of stroke and smoking were significantly associated with stroke (p<0.05).
Conclusions The prevalence of stroke, the related risk factors and the detection rate of high-risk individuals were clarified. The prevalence rates of hypertension, overweight or obesity and diabetes in the Qinghai-Tibet Plateau were all higher than the Chinese average. Higher-altitude exposure may be an independent risk factor for stroke.
- stroke
- epidemiology
- quality in health care
Data availability statement
Data are available upon reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available upon reasonable request.
Footnotes
Contributors ZHL was the first author. QZH is the corresponding author, responsible for the overall content as the guarantor. QZH obtained funding. ZHL, QZH and WZJ conceived and designed the study. ZHL and QLF analysed the data. ZHL drafted the manuscript. ZHL and QZH contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. All authors approved the final version to be published.
Funding This work was supported by the Qinghai Provincial Department of Science and Technology (2019-ZJ-7051).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.