Basics of a personalized approach to stroke prevention in urban and rural residents of the Arctic macro-region

Background. To achieve maximum results when preventing stroke requires studying the factors determining the difference in the preventive measures.

The aim. To study differences in the gender-age characteristics, stroke type structure and the prevalence of concomitant diseases in urban and rural patients with stroke living in the Arkhangelsk region.

Materials and methods. The results of a retrospective study among 5227 patients with acute stroke discharged from City (3588) and Regional (1639) Hospitals are presented (January 2017 – December 2020). Gender-age, stroke types, presence and number of concomitant diseases, place of residence were analyzed.

Results. Older age groups were more numerous in urban (p < 0.001), with a predominance of women over 80 (p < 0.001). In 50–69 group urban patients had more cryptogenic strokes (p < 0.001), regional patients had more atherothrombotic and lacunar strokes (p < 0.001). A higher comorbidity burden was found among urban (5, 6, 7 diseases) (p < 0.001; p < 0.001 and p = 0.002). In patients over 80, arterial hypertension (AH), atrial fibrillation (AF), coronary heart disease (CHD), chronic heart failure (CHF), post-infarction cardiosclerosis (PICS), diabetes mellitus (DM) (p < 0.001) was more common in urban female. In 50–69 age women AH, CA, CHF (p < 0.001) and CHD (p = 0.001) were more often in rural. Among men over 70 AH, DM, AF, PICS (p < 0.001), CA (p = 0.003) and cancer (p = 0.007) were more often in urban. In 50–69 age men AH, CHD and CHF (p < 0.001) predominated in rural.

Conclusion. The identified differences determine the basis for a shift in emphasis in the development of preventive measures in the region under study.

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