BACKGROUND AND PURPOSE: Markers of low socioeconomic status (deprivation) are associated with stroke and its causes. In the United Kingdom, area-based deprivation measures are available routinely through links with postal codes. We hypothesized that deprivation is associated with ischemic stroke risk factors, severity, subtype, and outcome. METHODS: We studied 2026 patients, each with at least 2 years of outcome follow-up by record linkage after first admission with ischemic stroke to an acute stroke unit. Baseline factors recorded routinely were age, sex, medical history, blood pressure, and stroke severity and subtype. Deprivation was assessed by the Womersley score (WS) and Murray score (MS). RESULTS: Higher WS and MS were associated with stroke at younger age (eg, WS linear regression coefficient (r)=-0.26; 95% confidence interval [CI], -0.51 to -0.01 per additional point), smoking (odds ratio [OR], 1.12; 95% CI, 1.08 to 1.17), and claudication (OR, 1.09; 95% CI, 1.01 to 1.17); WS was associated with higher systolic blood pressure (r=0.13; 95% CI, 0.02 to 0.24); and MS was associated with severe stroke. Deprivation was not associated with case fatality in univariate analysis or after correction for all baseline factors. Deprivation was associated with readmission to hospital as a result of any vascular event in univariate analysis (hazard ratio [HR], 1.05; 95% CI, 1.02 to 1.09) and after correction for all baseline factors (HR, 1.06; 95% CI, 1.02 to 1.10). CONCLUSIONS: Tackling health inequalities in stroke should focus on stroke primary prevention by tackling deprivation, including promoting changes in lifestyle.
BACKGROUND AND PURPOSE: Markers of low socioeconomic status (deprivation) are associated with stroke and its causes. In the United Kingdom, area-based deprivation measures are available routinely through links with postal codes. We hypothesized that deprivation is associated with ischemic stroke risk factors, severity, subtype, and outcome. METHODS: We studied 2026 patients, each with at least 2 years of outcome follow-up by record linkage after first admission with ischemic stroke to an acute stroke unit. Baseline factors recorded routinely were age, sex, medical history, blood pressure, and stroke severity and subtype. Deprivation was assessed by the Womersley score (WS) and Murray score (MS). RESULTS: Higher WS and MS were associated with stroke at younger age (eg, WS linear regression coefficient (r)=-0.26; 95% confidence interval [CI], -0.51 to -0.01 per additional point), smoking (odds ratio [OR], 1.12; 95% CI, 1.08 to 1.17), and claudication (OR, 1.09; 95% CI, 1.01 to 1.17); WS was associated with higher systolic blood pressure (r=0.13; 95% CI, 0.02 to 0.24); and MS was associated with severe stroke. Deprivation was not associated with case fatality in univariate analysis or after correction for all baseline factors. Deprivation was associated with readmission to hospital as a result of any vascular event in univariate analysis (hazard ratio [HR], 1.05; 95% CI, 1.02 to 1.09) and after correction for all baseline factors (HR, 1.06; 95% CI, 1.02 to 1.10). CONCLUSIONS: Tackling health inequalities in stroke should focus on stroke primary prevention by tackling deprivation, including promoting changes in lifestyle.
Authors: Dawn Kleindorfer; Christopher Lindsell; Kathleen A Alwell; Charles J Moomaw; Daniel Woo; Matthew L Flaherty; Pooja Khatri; Opeolu Adeoye; Simona Ferioli; Brett M Kissela Journal: Stroke Date: 2012-07-05 Impact factor: 7.914
Authors: Cari Jo Clark; Hongfei Guo; Scott Lunos; Neelum T Aggarwal; Todd Beck; Denis A Evans; Carlos Mendes de Leon; Susan A Everson-Rose Journal: Stroke Date: 2011-04-14 Impact factor: 7.914
Authors: Arleen F Brown; Li-Jung Liang; Stefanie D Vassar; Sharon Stein Merkin; W T Longstreth; Bruce Ovbiagele; Tingjian Yan; José J Escarce Journal: Neurology Date: 2013-01-02 Impact factor: 9.910
Authors: Arleen F Brown; Li-Jung Liang; Stefanie D Vassar; Sharon Stein-Merkin; W T Longstreth; Bruce Ovbiagele; Tingjian Yan; José J Escarce Journal: Stroke Date: 2011-09-22 Impact factor: 7.914
Authors: Jaime E Mirowsky; Robert B Devlin; David Diaz-Sanchez; Wayne Cascio; Shannon C Grabich; Carol Haynes; Colette Blach; Elizabeth R Hauser; Svati Shah; William Kraus; Kenneth Olden; Lucas Neas Journal: J Expo Sci Environ Epidemiol Date: 2016-09-21 Impact factor: 5.563
Authors: Parker Magin; Anousha Victoire; Xi May Zhen; John Furler; Marie Pirotta; Daniel S Lasserson; Christopher Levi; Amanda Tapley; Mieke van Driel Journal: Stroke Date: 2013-07-30 Impact factor: 7.914