Living standard is related to microregional differences in stroke characteristics in Central Europe: the Budapest Districts 8-12 Project

Abstract

Objectives: To test whether str oke features relate to living standard within one city by comparing 2 districts.

Methods: District-8 (D-8) ranks the last, whereas District-12 (D-12) is the second regarding personal monthly income of the 23 districts of Budapest, Hungary. Stroke cases hospitalized in 2007 were identified by the database of the National Health Insurance Fund and postal codes for living address. Case certification was performed by personal visits to the general practitioners. Demographic data, risk factors and survival status in 2010 were analyzed using the anonymized database.

Results: Three-year case fatality was 36.6 % in D-8 and 31.5 % in D-12 (p = 0.24). Of the fatal cases, men were more than 12 years younger in D-8 than in D-12 (69.2 ± 13.3 vs. 82.4 ± 9.2 years, p < 0.001). Men died younger than women in D-8 (69.2 ± 13.3 vs. 75.2 ± 12.4; p = 0.036), but not in D-12 (82.4 ± 9.2 vs. 81.9 ± 7.3, p = 0.8). Non-treated hypertension, alcohol dependence, and smoking were significantly more prevalent in the poor district (p < 0.01 for all).

Conclusion: In national stroke programs of former Eastern Block countries, primary prevention should focus especially on male populations of less wealthy regions.