Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Vanessa Speckhahn Vicente; Norberto Luiz Cabral; Vivian Nagel; Vanessa V Guesser; Juliana Safanelli

doi:10.1590/0004-282X20180053

Arquivos de Neuro-Psiquiatria, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(06): 367-372
DOI: 10.1590/0004-282X20180053

ARTICLE

Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Prevalência de excesso de peso em pacientes com acidente vascular cerebral em cinco cidades brasileiras

Autoren

Vanessa Speckhahn Vicente

²Universidade de Joinville (Univille), Joinville SC, Brasil.
Norberto Luiz Cabral

¹Registro de AVC de Joinville, Joinville SC, Brasil;

²Universidade de Joinville (Univille), Joinville SC, Brasil.
Vivian Nagel

¹Registro de AVC de Joinville, Joinville SC, Brasil;
Vanessa V Guesser

¹Registro de AVC de Joinville, Joinville SC, Brasil;
Juliana Safanelli

¹Registro de AVC de Joinville, Joinville SC, Brasil;

Abstract

ABSTRACT

Objective There is gap in knowledge about obesity prevalence in stroke patients from low- and middle-income countries. Therefore, we aimed to measure the prevalence of overweight and obesity status among patients with incident stroke in Brazil.

Methods In a cross-sectional study, we measured the body mass index (BMI) of ischemic and hemorrhagic stroke patients. The sample was extracted in 2016, from the cities of Sobral (CE), Sertãozinho (SP), Campo Grande (MS), Joinville (SC) and Canoas (RS).

Results In 1,255 patients with first-ever strokes, 64% (95% CI, 62–67) were overweight and 26% (95%CI, 24–29) were obese. The obesity prevalence ranged from 15% (95%CI, 9–23) in Sobral to 31% (95%CI, 18–45) in Sertãozinho. Physical inactivity ranged from 53% (95%CI, 43-63) in Sobral to 80% (95%CI, 73–85) in Canoas.

Conclusions The number of overweight patients with incident stroke is higher than the number of patients with stroke and normal BMI. Although similar to other findings in high-income countries, we urgently need better policies for obesity prevention.

RESUMO

Objetivo Há uma lacuna de conhecimento sobre a prevalência de obesidade em pacientes com AVC (acidente vascular cerebral) de países de baixa e média renda. Portanto, objetivamos medir a prevalência de sobrepeso e obesidade entre pacientes com AVC no Brasil.

Métodos Em um estudo transversal, medimos o índice de massa corporal (IMC) em pacientes com AVC isquêmico e hemorrágico. A amostra foi extraída em 2016, nas cidades de Sobral (CE), Sertãozinho (SP), Campo Grande (MS), Joinville (SC) e Canoas (RS).

Resultados Entre 1255 casos de AVC, 64% (95%CI, 62–67) apresentavam sobrepeso e 26% (95%CI, 24–29) obesidade. A prevalência de obesidade variou de 15% (95%CI, 9–23) em Sobral a 31% (95%CI, 18–45) em Sertãozinho.

Conclusões A quantidade de pacientes com AVC e IMC anormal é maior do que a de pacientes com AVC e IMC normal. Embora esta prevalência seja similar às de países de alta renda, precisamos urgentemente de melhores políticas de prevenção da obesidade. Atividade física deveria ser parte da prescrição médica.

obesity - prevalence - stroke, epidemiology - cross-sectional studies

obesidade - prevalência - acidente vascular cerebral, epidemiologia - estudos transversais

Volltext

Referenzen

References
1 World Health Organization – WHO. 10 facts on obesity. Geneva: World Health Organization; 2017 [cited 2017 Apr 20]. Available from: http://www.who.int/features/factfiles/obesity/en/
2 Ministério da Saúde (BR). Plano de ações estratégicas para o enfrentamento das Doenças Crçnicas Não Transmissíveis (DCNT) no Brasil 2011–2022. Brasília, DF: Ministério da Saúde; 2011 [cited 2016 May 5]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/plano_acoes_enfrent_dcnt_2011.pdf
3 Arbex AK, Rocha DR, Aizenberg M, Ciruzzi MS. Obesity epidemic in Brazil and Argentina: a public health concern. J Health Popul Nutr. 2014 Jun;32(2):327-34. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216968/
4 Kernan WN, Inzucchi SE, Sawan C, Macko RF, Furie KL. Obesity: a stubbornly obvious target for stroke prevention. Stroke. 2013 Jan;44(1):278-86. https://doi.org/10.1161/STROKEAHA.111.639922
5 Kernan WN, Dearborn JL. Obesity increases stroke risk in young adults: opportunity for prevention. Stroke. 2015 Jun;46(6):1435-6. https://doi.org/10.1161/STROKEAHA.115.009347
6 Ministério da Saúde (BR). DATASUS. Estatísticas vitais. 2015 [cited 2015 Aug 20]. Available from: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?ibge/cnv/popsc.def
7 Truelsen T, Heuschmann PU, Bonita R, Arjundas G, Dalal P, Damasceno A et al. Standard method for developing stroke registers in low-income and middle-income countries: experiences from a feasibility study of a stepwise approach to stroke surveillance (STEPS Stroke). Lancet Neurol. 2007 Feb;6(2):134-9. https://doi.org/10.1016/S1474-4422(06)70686-X
8 Cabral NL, Cougo-Pinto PT, Magalhaes PS, Longo AL, Moro CH, Amaral CH et al. Trends of stroke incidence from 1995 to 2013 in Joinville, Brazil. Neuroepidemiology. 2016;46(4):273-81. Available from: https://doi.org/10.1159/000445060
9 Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA et al.; American Heart Association. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007 Aug;116(9):1081-93. https://doi.org/10.1161/CIRCULATIONAHA.107.185649
10 The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581-8. https://doi.org/10.1056/NEJM199512143332401
11 Associação de Empresas Brasileiras de Pesquisa. Critério de classificação econçmica Brasil. São Paulo: ABEP; 2008.
12 World Health Organization – WHO. The World Health Report 2000: health systems: improving performance. Geneva, World Health Organization; 2000.
13 Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993 Jan;24(1):35-41. https://doi.org/10.1161/01.STR.24.1.35
14 Oliveira-Filho J, Martins SC, Pontes-Neto OM, Longo A, Evaristo EF, Carvalho JJ et al. Guidelines for acute ischemic stroke treatment: part I. Arq Neuropsiquiatr. 2012 Aug;70(8):621-9. https://doi.org/10.1590/S0004-282X2012000800012
15 World Health Organization – WHO. WHO obesity and overweight. 2016 [cited 2016 Sep 15]. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/
16 Baggio JA, Santos-Pontelli TE, Cougo-Pinto PT, Camilo M, Silva NF, Antunes P et al. Validation of a structured interview for telephone assessment of the modified Rankin Scale in Brazilian stroke patients. Cerebrovasc Dis. 2014;38(4):297-301. https://doi.org/10.1159/000367646
17 Chong JY, Sacco RL. Epidemiology of stroke in young adults: race/ethnic differences. J Thromb Thrombolysis. 2005 Oct;20(2):77-83. https://doi.org/10.1007/s11239-005-3201-9
18 Dehlendorff C, Andersen KK, Olsen TS. Body mass index and death by stroke: no obesity paradox. JAMA Neurol. 2014 Aug;71(8):978-84. https://doi.org/10.1001/jamaneurol.2014.1017
19 Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014 Aug;384(9945):766-81. https://doi.org/10.1016/S0140-6736(14)60460-8
20 George MG, Tong X, Bowman BA. Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. JAMA Neurol. 2017 Jun;74(6):695-703. https://doi.org/10.1001/jamaneurol.2017.0020
21 Aparicio HJ, Himali JJ, Beiser AS, Davis-Plourde KL, Vasan RS, Kase CS et al. Overweight, Obesity, and Survival After Stroke in the Framingham Heart Study. J Am Heart Assoc. 2017 Jun;6(6):e004721. https://doi.org/10.1161/JAHA.116.004721
22 Hu G, Tuomilehto J, Silventoinen K, Sarti C, Männistö S, Jousilahti P. Body mass index, waist circumference, and waist-hip ratio on the risk of total and type-specific stroke. Arch Intern Med. 2007 Jul;167(13):1420-7. https://doi.org/10.1001/archinte.167.13.1420
23 Wang C, Liu Y, Yang Q, Dai X, Wu S, Wang W et al. Body mass index and risk of total and type-specific stroke in Chinese adults: results from a longitudinal study in China. Int J Stroke. 2013 Jun;8(4):245-50. https://doi.org/10.1111/j.1747-4949.2012.00830.x
24 Mitchell AB, Cole JW, McArdle PF, Cheng YC, Ryan KA, Sparks MJ et al. Obesity increases risk of ischemic stroke in young adults. Stroke. 2015 Jun;46(6):1690-2. https://doi.org/10.1161/STROKEAHA.115.008940
25 Park JH, Lee J, Ovbiagele B. Association of Optimal Combination Drug Treatment with Obesity Status among Recent Ischemic Stroke Patients: Results of the Vitamin Intervention for Stroke Prevention (VISP) Trial. J Stroke. 2017 May;19(2):213-21. https://doi.org/10.5853/jos.2016.01347
26 Doehner W, Schenkel J, Anker SD, Springer J, Audebert HJ. Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack: observations from the TEMPiS trial. Eur Heart J. 2013 Jan;34(4):268-77. https://doi.org/10.1093/eurheartj/ehs340
27 Wang A, Wu J, Zhou Y, Guo X, Luo Y, Wu S et al. Measures of adiposity and risk of stroke in China: A result from the Kailuan study. PLoS One. 2013 Apr;8(4):e6165. https://doi.org/10.1371/journal.pone.0061665
28 Strazzullo P, D’Elia L, Cairella G, Garbagnati F, Cappuccio FP, Scalfi L. Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. Stroke. 2010 May;41(5):e418-26. https://doi.org/10.1161/STROKEAHA.109.576967