Abdominal obesity as a risk factor for stroke in Abuja, Nigeria

Obesity in Africa has remained a public health concern, which is been fueled by urbanization and its attendant lifestyle changes which include less energy demanding jobs, sedentary lifestyle, and adopting detrimental western eating habits. There are well-established risk factors for stroke; however, the association of obesity with that of stroke is less clear. This study was designed to determine whether abdominal obesity is independently associated with an increased risk of ischemic stroke. It is a case-control study of 113 patients in which a structured questionnaire was administered to consecutive patients admitted into the medical wards. The controls were matched for age and sex from a database with participants of the population-based cohort study. Statistical analysis of data was performed using SAS software (SAS Institute) 9.4. In the study 85% of the patients had hypertension, 50.5% had hypercholesterolemia and 33.6% had diabetes. The BMI was normal for most of the cases (23.3% vs. 76.7% p<0.0001) while the WHR was increased for most of the cases (70.9% vs. 29.1% p<0.0001). The statistical significance shows that WHR was more sensitive in assessing obesity than BMI. The logistic regression analysis, in model 1 unadjusted and model 2 adjusted for sex and age, BMI showed a positive association with risk of stroke (OR 1.10; 95% CI: 1.04-1.17; p: 0.002) this association lost its significance in model 3 after adjusting for diabetes, hypertension and hypercholesterolemia (OR 1.04; 95% CI: 0.96-1.13; p: 0.3751). The results of logistic regression analysis for WHR for model 1, model 2, and model 3 did not show any significance before and after adjustment. In conclusion, abdominal obesity may increase the risk of ischemic stroke through conventional vascular risk factors, but not as an independent risk factor.