SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites.
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Kumaravelu Somasundaram, Verma Shweta Jain, Arora Rimpi, Arora Deepti, Arya Devi K S, Dhasan Aneesh, Sylaja Padmavathyamma Narayanapillai, Khurana Dheeraj, Vijaya Pamidimukkala, Ray Biman, Nambiar Vivek, Aaron Sanjith, Mittal Gaurav, Nagarjunakonda Sundarachary, Pai Aparna, Reddy Yerasu Muralidhar, Narayan Sunil, Borah Nomal, Das Rupjyoti, Kulkarni Girish, Huded Vikram, Mathew Thomas, Srivastava Madakasira Vasantha Padma, Bhatia Rohit, Ojha Pawan, Roy Jayanta, Abraham Sherly, Vaishnav Anand, Sharma Arvind, Jabeen Shaikh Afshan, Pathak Abhishek, Bhoi Sanjeev, Sharma Sudhir, Sulena Sulena, Saroja Aralikatte Onkarappa, Ramrakhiani Neetu, Kempegowda Madhusudhan Byadarahalli, Gorthi Sankar, Kate Mahesh, George Tina, Sebastian Ivy, Sharma Meenakshi, Dhaliwal Rupinder, Huilgol Rahul, Pandian Jeyaraj Durai
Аннотация
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.