South African Medical Journal

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The South African Stroke Risk in General Practice Study

Myles Connor, Paul Rheeder, Alan Bryer, Megan Meredith, Marlene Beukes, Asher Dubb, Vivian Fritz


Background. Incidence of stroke is increasing in sub-Saharan Africa and stroke prevention is an  essential component of successful stroke management. General practitioners (GPs) ate well placed to manage stroke risk factors. To design appropriate strategies for risk factor reduction we need to know the risk factor prevalence in each of the population groups attending GPs. The aim of this study was to  establish the prevalence of stroke risk factors in the South African general practice population.

Method. We conducted a multicentre, observational study of patients attending general practice in South Africa. Two hundred general practices were randomly selected from lists provided by  pharmaceutical .representatives. Each GP approached 50 consecutive patients aged 30 years and older. Patients completed an information sheet and the GP documented the patient's risk factors. The resulting  sample is relevant.if not necessarily representative in a statistical sense.

Results. A total of 9 731 questionnaires were returned out of a possible 10 000. The mean age of  particpants was 50.7 years. Seventy-six per cent had 1 or more risk factors and 40% had 2 or more risk factors. Hypertension was the commonest risk factor in all population groups (55%) but was highest in black patients (59%). Dyslipidaemia was commonest in whites (37%) and least common in blacks (5%). Diabetes was commonest in Asians (24%) but least common in whites (8%). Risk factors other than smoking increased with age.

Conclusion. This study provides unique data on the prevalence of stroke risk factors in a South African general practice population. Risk factors are common in all population groups, but differ in distribution among the groups. There is considerable opportunity to reduce the burden  of stroke in South Africa through GP screening for and treatment of risk factors.

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