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Reported Stroke Symptoms and their Associated Risk Factors in the Kingdom of Saudi Arabia, 2013

Abstract

Charbel El Bcheraoui, Mohammed Basulaiman, Mohammad A AlMazroa, Farah Daoud, Marwa Tuffaha, Shelley Wilson, Diego Gonzalez-Medina, Ziad A Memish, Mohammed Al Saeedi, and Ali H Mokdad

Background: Stroke is the second leading cause of death globally, and in the Kingdom of Saudi Arabia, with hypertension being the predominant risk factor. At-risk individuals experience stroke symptoms but remain undiagnosed. However, no data exist on stroke symptoms and their associated factors in KSA. We assessed self-reported stroke symptoms and their association with pre-diabetes, diabetes, hypercholesterolemia, hypertension, and health seeking behaviors.

Methods: We conducted a nationally representative multistage survey of individuals aged 15 years or older on socio-demographic characteristics; tobacco consumption, diet, physical activity, health care utilization, different health related behaviors, and self-reported chronic conditions. We used a backward elimination multivariate logistic regression model to measure associations between symptoms of stroke and risk factors.

Results: Between April and June 2013, a total of 12,000 households were contacted and a total of 10,735 participants completed the survey (response rate of 89.4%). Overall, 579 (4.8% age-adjusted) respondents reported experiencing at least one symptom of stroke, while 55 (0.4% age-adjusted) reported being previously diagnosed with a stroke. The likelihood of reporting symptoms of stroke was associated with sex, older age, high levels of physical activity, and a history of diagnoses of any of the following conditions: pre-diabetes, diabetes, hypercholesterolemia, and hypertension. Our study showed that a high percentage of Saudis reporting stroke symptoms have undiagnosed or uncontrolled blood pressure. Moreover, 61%% of those reporting stroke symptoms have never been to a doctor.

Conclusions: Our study showed that a high percentage of individuals with suspected stroke have not sought medical care. Moreover, a large proportion of those with reported symptoms have uncontrolled conditions. To reduce the burden on stroke in KSA, prevention and control strategies should be accelerated with a focus on use of free preventive care services.