title: Stroke incidence and risk factors in Havana and Matanzas, Cuba.
abstract: BACKGROUND
  Cerebrovascular disease is the third-leading cause of death and the second-leading cause of disability and dementia.
  
  
  OBJECTIVE
  Determine stroke incidence and risk factors in a population of adults aged 65 and over in Cuba (Havana and Matanzas).
  
  
  METHODS
  This prospective longitudinal study, completed between April 2008 and Abril 2011, re-evaluated 2916 elderly adults with an average follow-up time of 4 years. Cases included 2316 living subjects and 600 verbal autopsies. Study variables were age, sex, educational level, self-reported health, and description of chronic diseases and substance abuse. Laboratory tests included genotyping APOE. Stroke was diagnosed based on the World Health Organization definition. We calculated the global incidence rate for stroke, broken down by sex, age group, and risk factors for incident stroke.
  
  
  RESULTS
  Stroke incidence was 786.2 in 100000 persons/year (95% CI: 672.3-906.4). History of alcohol consumption (HR: 3.5; 95% CI: 3.3-3.7), dementia (HR: 3.0; 95% CI, 1.6-5.5) and male sex (HR: 1.8; 95% CI, 1.2-2.8) were shown to be risk factors for incident stroke.
  
  
  CONCLUSIONS
  Stroke incidence was similar to rates reported in developed countries and lower than that in low- to middle-income countries. Given that diabetes mellitus, heart disease, arterial hypertension, smoking, APOE4, etc. are associated with higher mortality rates, they will require separate analysis in a study of stroke risk factors.
authors.affiliation: Departamento de Neurología, Unidad de Ictus, Instituto de Neurología y Neurocirugía, Universidad Médica de La Habana, La Habana, Cuba. Electronic address: pereraelianne@infomedsld.cu.
authors.forename: J C
authors.initials: JC
authors.lastname: Llibre-Guerra
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Faustino Pérez, Matanzas, Cuba.
authors.forename: A
authors.initials: A
authors.lastname: Valhuerdi Cepero
authors.affiliation: Departamento de Neurología, Unidad de Ictus, Instituto de Neurología y Neurocirugía, Universidad Médica de La Habana, La Habana, Cuba.
authors.forename: O
authors.initials: O
authors.lastname: Fernández Concepción
authors.affiliation: Departamento de Neurología, Unidad de Ictus, Instituto de Neurología y Neurocirugía, Universidad Médica de La Habana, La Habana, Cuba.
authors.forename: J J
authors.initials: JJ
authors.lastname: Llibre-Guerra
authors.affiliation: Centro de Estudios de Alzheimer, Universidad Médica de La Habana, La Habana, Cuba.
authors.forename: R F
authors.initials: RF
authors.lastname: Gutiérrez
authors.affiliation: Departamento de Medicina Familiar, AC Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: J J
authors.initials: JJ
authors.lastname: Llibre-Rodriguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003462:Cuba / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*
keywords: Apolipoprotein E4; Apolipoproteína E4; Factores de riesgo; Ictus; Incidence; Incidencia; Risk factors; Stroke