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. 2025 May 1;28(3):378-386.
doi: 10.4103/aian.aian_792_24. Epub 2025 May 7.

SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites

Somasundaram Kumaravelu  1 , Shweta Jain Verma  2 , Rimpi Arora  2 , Deepti Arora  2 , K S Arya Devi  2 , Aneesh Dhasan  3 , Padmavathyamma Narayanapillai Sylaja  3 , Dheeraj Khurana  4 , Pamidimukkala Vijaya  5 , Biman Ray  6 , Vivek Nambiar  7 , Sanjith Aaron  8 , Gaurav Mittal  9 , Sundarachary Nagarjunakonda  10 , Aparna Pai  11 , Yerasu Muralidhar Reddy  12 , Sunil Narayan  13 , Nomal Borah  14 , Rupjyoti Das  14 , Girish Kulkarni  15 , Vikram Huded  16 , Thomas Mathew  17 , Madakasira Vasantha Padma Srivastava  18 , Rohit Bhatia  18 , Pawan Ojha  19 , Jayanta Roy  20 , Sherly Abraham  21 , Anand Vaishnav  22 , Arvind Sharma  23 , Shaikh Afshan Jabeen  24 , Abhishek Pathak  25 , Sanjeev Bhoi  26 , Sudhir Sharma  27 , Sulena Sulena  28 , Aralikatte Onkarappa Saroja  29 , Neetu Ramrakhiani  30 , Madhusudhan Byadarahalli Kempegowda  31 , Sankar Gorthi  11 , Mahesh Kate  32 , Tina George  8 , Ivy Sebastian  9 , Meenakshi Sharma  33 , Rupinder Dhaliwal  33 , Rahul Huilgol  2 , Jeyaraj Durai Pandian  2
Affiliations

SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites

Somasundaram Kumaravelu et al. Ann Indian Acad Neurol. .

Abstract

Background and objectives: Regional differences in stroke prevalence and outcomes in India, driven by demographic and risk factors, are crucial for guiding effective prevention and management strategies. This subanalysis of Secondary prevention with a structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA) randomized controlled trial compared the demographics, risk factors, and clinical outcomes of stroke patients from North and South India to identify regional differences and inform targeted interventions for stroke prevention.

Methods: The study analyzed data of 4298 participants from 31 stroke centers across India, focusing on demographics, stroke types, and risk factors. In this study, Mumbai, located at 19.07°N in western India, serves as the dividing line between North and South India. One-year follow-up data from 3038 patients were utilized to examine regional disparities between North and South India.

Results: South Indian stroke patients were predominantly rural (60.1%) and less educated (58.2%), while North Indian patients were mostly urban (64.2%). South Indian patients had higher incidence of ischemic stroke (91.1% vs. 73.5%, P = 0.001) and higher rates of large artery atherosclerosis (33.6% vs. 19.7%, P = 0.001), hypertension, type 2 diabetes, smoking, and alcohol consumption, but better medication adherence. In contrast, North Indian patients had higher high-density lipoprotein, drug use, and tobacco use. At 1-year follow-up, North Indian patients had more high-risk transient ischemic attacks and poorer lifestyle-related outcomes, despite South Indians having higher systolic blood pressure and fasting glucose levels.

Conclusion: Region-specific strategies are crucial. Block randomization may help. South India needs better lifestyle modification programs, while North India requires improved health education and medication adherence strategies.Trial registration: CTRI/2017/09/009600.

Trial registration: ClinicalTrials.gov NCT03228979.

Keywords: Stroke; cardiovascular events; prevention; regional variations; risk factors.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
SPRINT INDIA: Study design and participants. SPRINT INDIA: secondary prevention by structured semi-interactive stroke prevention package in INDIA
See this image and copyright information in PMC

References

    1. Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795–820. - PMC - PubMed
    1. Jones SP, Baqai K, Clegg A, Georgiou R, Harris C, Holland EJ, et al. Stroke in India: A systematic review of the incidence, prevalence, and case fatality. Int J Stroke. 2022;17:132–40. - PMC - PubMed
    1. Dalal PM, Malik S, Bhattacharjee M, Trivedi ND, Vairale J, Bhat P, et al. Population-based stroke survey in Mumbai, India: Incidence and 28-day case fatality. Neuroepidemiology. 2008;31:254–61. - PubMed
    1. Singh S, Kate M, Samuel C, Kamra D, Kaliyaperumal A, Nandi J, et al. Rural stroke surveillance and establishment of acute stroke care pathway using frontline health workers in rural northwest India: The Ludhiana experience. Neuroepidemiology. 2021;55:297–305. - PubMed
    1. Ray BK, Hazra A, Ghosal M, Banerjee T, Chaudhuri A, Singh V, et al. Early and delayed fatality of stroke in Kolkata, India: Results from a 7-year longitudinal population-based study. J Stroke Cerebrovasc Dis. 2013;22:281–9. - PubMed

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