Risk Factors for Ischaemic Stroke in an Omani Community: A case-control study

Objectives: Stroke is recognized to be the third most common cause of mortality, with increasing incidence among developing countries. Recognition and control of risk factors is of prime importance in the prevention of stroke. We aimed to study the characteristics of ischemic stroke (IS) patients in Oman, and quantify its various risk factors using a case-control model. Methods: This study conducted from January 2012 to March 2013 included 255 adult Omani patients with IS admitted to two premier hospitals in Oman, compared to 255 age- and gender-matched controls. Demographic factors and frequency of various conventional risk factors were documented. Univariate and step-wise multivariate logistic regression analysis were performed to evaluate the risk factors associated for IS. Results: Of the 255 cases, 63% were males. The mean age was 62.2 ± 13.2 years. Most of the cases (89%)  were above 45 years of age. Cardio-embolism(32%) was the commonest mechanism of IS. The stepwise multiple logistic regression model revealed that family history of stroke was the strongest independent risk factor with odds ratio (OR) of 10.10, followed by hypertension with OR of 5.17 and high-density lipoprotein with OR 3.34 (p< 0.01). Conclusions: Cardio-embolism was the predominant mechanism of IS in this study. Family history of stroke, hypertension and reduced high-density lipoprotein were the leading independent risk factors. Strong emphasis on screening for risk factors, control of hypertension and life-style modification for those with family history of stroke, would be expected to emerge as the major stroke-preventive measures in Oman. Keywords:  Ischemic stroke; Risk factors; Case-control study; Oman.