The population attributable fraction of stroke associated with high blood pressure in the Middle East and North Africa

Background: Hypertension and the prevalence of stroke are increasing in the Middle East and North Africa. This study aims to quantify the contribution of hypertension to the development of stroke at the country-level by calculating the sex-specific population attributable fraction (PAFs). Methods: The most recent sex-specific prevalence data was used, along with age-adjusted hazard ratio (HR) estimates for ischemic and hemorrhagic stroke associated with hypertension from the Asia Pacific Cohort Studies Collaboration (APCSC). HR estimates and prevalence data were then used to calculate the PAFs for each country in the region with the relevant data. Results: In the 10 countries with nationally-representative data, the PAFs in men ranged from 16.3% in Kuwait to 60.7% in Morocco for hemorrhagic stroke and 7.2% in Kuwait to 38% in Morocco for ischemic stroke. The equivalent PAFs for stroke deaths related to hypertension in women ranged from 12.4% in United Arab Emirates to 48.6% in Bahrain for hemorrhagic stroke and from 10.3% in UAE to 46% in Morocco for ischemic stroke. Conclusion: Overall, up to 60% of stroke can be attributed to the high blood pressure in the Middle East. Stroke is a preventative disease, with this information and better prevention strategies, this region can aim to lower the prevalence of stroke. (C) 2011 Elsevier B.V. All rights reserved.