Stroke at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a cross-sectional analysis

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP ABREU, Fernanda Gabriela de FMUSP-HC
GOULART, Alessandra Carvalho FMUSP-HC
BIRCK, Marina Gabriela FMUSP-HC
BENSENOR, Isabela Martins FMUSP-HC 2018
dc.identifier.citation SAO PAULO MEDICAL JOURNAL, v.136, n.5, p.398-406, 2018
dc.identifier.issn 1516-3180
dc.description.abstract BACKGROUND: Secondary prevention of stroke is a very important goal for achieving continuous reduction in stroke mortality rates over the next decades. DESIGN AND SETTING: Cross-sectional analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), with data from Salvador, Vitoria, Belo Horizonte, Rio de Janeiro, Sao Paulo and Porto Alegre. METHODS: This descriptive analysis focused on secondary prevention of stroke among participants who self-reported a medical diagnosis of stroke at the baseline of ELSA-Brasil, and its association with sociodemographic characteristics. RESULTS: Overall, 197 participants (13%) reported a prior medical history of stroke. Participants with stroke were older and less educated and had lower mean monthly family income, compared with nonstroke participants. Among all stroke cases, 23.7% did not use any medication for secondary prevention of stroke. Use of secondary prevention was higher among men than among women (respectively, 59.6% versus 40.4%; P = 0.02 for aspirin; and 71.4% versus 28.6%; P = 0.04 for other antiplatelet drugs). Having private health insurance was associated with greater use of less cost-effective and more expensive medications (like angiotensinogen receptor blockers) and a tendency to use antiplatelet drugs other than aspirin, among participants reporting stroke, compared with others. Use of medication decreased as time passed after suffering a stroke. CONCLUSIONS: In this sample of individuals with better access to healthcare services, use of secondary prevention for stroke was low, which may suggest that the situation in the general population is worse. Sex was the most important sociodemographic variable associated with low use of secondary prevention.
dc.description.sponsorship · Brazilian Ministry of Health (Science and Technology Department)
· Brazilian Ministry of Science and Technology
· CNPq National Research Council [01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ]
· CNPq
dc.language.iso eng
dc.relation.ispartof Sao Paulo Medical Journal
dc.rights openAccess
dc.subject Cerebrovascular disorders; Stroke; Risk factor; Secondary prevention
dc.subject.other cardiovascular-disease prevention; global burden; hypertension; awareness; mortality; trends; availability; prevalence; management; adherence
dc.title Stroke at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a cross-sectional analysis
dc.type article
dc.rights.holder Copyright ASSOCIACAO PAULISTA MEDICINA LIM/20 LIM/51
dc.identifier.doi 10.1590/1516-3180.2018.0129060818
dc.identifier.pmid 30570091
dc.type.category original article
dc.type.version publishedVersion ABREU, Fernanda Gabriela de:FM: GOULART, Alessandra Carvalho:HU:SCPACEX-62 BIRCK, Marina Gabriela:FM: BENSENOR, Isabela Martins:FM:MCM WOS:000454008600003 2-s2.0-85058897935 SCIELO:S1516-31802018000500398 SAO PAULO BRAZIL
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