Prevalence of Stroke and Stroke Risk Factors in Thailand: Thai Epidemiologic Stroke (TES) Study
Suchat Hanchaiphiboolkul MD*, Niphon Poungvarin MD, FRCP**, Samart Nidhinandana MD***, Nijasri Charnnarong Suwanwela MD****, Pimchanok Puthkhao MSc*, Somchai Towanabut MD*, Tasanee Tantirittisak MD*, Jithanorm Suwantamee MD***, Maiyadhaj Samsen MD*
Affiliation : * Prasat Neurological Institute, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand ** Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Division of Neurology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand **** Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To assess stroke prevalence and stroke risk factors in Thailand.
Material and Method: Thai Epidemiologic Stroke (TES) Study is an ongoing, community based cohort study that has been
conducted in five geographic regions of Thailand. Baseline health status survey was started in 2004 and enrollment continued
until the end of 2006. All participants who were suspicious of being stroke victims were verified. In this analysis, baseline data
of 19,997 participants aged 45 to 80 years were identified and analyzed as a cross-sectional analysis.
Results : Three hundred and seventy six subjects were proved to have a stroke thus resulting the crude prevalence of stroke
to be 1.88% (95% CI, 1.69 to 2.07). Age standardization to Segi world standard population was 1.81% (95% CI, 1.62 to
1.99). Crude prevalence among adults aged > 65 years was 2.70% (95% CI, 2.28 to 3.11). Stroke prevalence differed among
five geographic regions of the country (Bangkok 3.34%, Central region 2.41%, Southern 2.29%, Northern 1.46% and
Northeastern 1.09%). Using multiple logistic regression analysis, factors associated with higher stroke prevalence were
male gender (p < 0.001), occupational class (p < 0.001), geographic region (p < 0.001), hypertension (p < 0.001), diabetes
mellitus (p = 0.002) and hypercholesterolemia (p = 0.026).
Conclusion : Stroke prevalence in Thailand from TES study is higher than previous studies, but it is lower than developed
countries, probably due to high case fatality rate in Thai population. Geographic variation in stroke prevalence is found more
in Bangkok, Central and Southern regions. Longitudinal follow-up of TES cohort study will provide further information on
risk factors and incidence of stroke.
Keywords : Prevalence of stroke, Stroke risk factors, Geographic gradient, Epidemiology of stroke, Thailand
