CVA Epidemiology

OT Dude Academy’s Free NBCOT® Exam Prep Course Stroke (CVA) CVA Epidemiology
  • Stroke is a preventable disease with risk factors that may be modifiable.1 
  • CVA risk factors are categorized as modifiable and nonmodifiable.2 
  • Non-modifiable
    • Age, sex, race.
  • Modifiable
    • Hypertension
    • Smoking
    • Diet
    • Physical inactivity
    • Diabetes
  • Stroke incidence increases with age. There is an increased trend of people aged 20-54 with strokes globally of 19% in 2016. Women tend to have stroke at younger ages and men tend to have it at older ages. Risk factors for women include pregnancy, preeclampsia, contraceptive use, and hormonal therapy. A-fib increases stroke risk for women over 75 years. Both brain infarction and intracerebral hemorrhage (ICH) are common in men, but cardioembolic stroke (more severe) is more prevalent among women. The fatality rate is higher among women due to women living longer. Smoking, excessive alcohol consumption, MI, and arterial disorders are common risk factors for men.3 4 5 
  • Risk factors include inflammatory disorders, infection, pollution, and cardiac atrial disorders.
  • Novel risk factors include sleep-disordered breathing, inflammatory markers, carotid thickness, and COPD.6 
  • 30 years of evidence shows a strong association between hypertension and stroke and this factor is important for the prevention of CVAs in the population.7 
  • There is a strong inverse relationship between stroke and socioeconomic status that is attributed to hospital facilities and post-stroke rehabilitation among low-income populations. In the US, people of higher SES had better stroke prognosis than those of lower SES.8 9 
  1. Bonita R, Beaglehole R, North JD: Event, incidence and case fatality rates of cerebrovascular disease in Auckland, New Zealand. Am J Epidemiol 120(2):236–243, 1984.[↩]
  2. Boehme, A. K., Esenwa, C., & Elkind, M. S. (2017). Stroke risk factors, genetics, and prevention. Circulation research, 120(3), 472-495.[↩]
  3. Boehme, A.K.; Esenwa, C.; Elkind, M.S. Stroke Risk Factors, Genetics, and Prevention. Circ. Res. 2017, 120, 472–495[↩]
  4. Appelros, P.; Stegmayr, B.; Terént, A. Sex differences in stroke epidemiology: A systematic review. Stroke 2009, 40, 1082–1090. [↩]
  5. Girijala, R.L.; Sohrabji, F.; Bush, R.L. Sex differences in stroke: Review of current knowledge and evidence. Vasc. Med. 2017, 22, 135–145.[↩]
  6. Arboix A. (2015). Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke. World journal of clinical cases, 3(5), 418–429. https://doi.org/10.12998/wjcc.v3.i5.418[↩]
  7. Goldstein LB, Adams R, Alberts MJ, et al. Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline. Stroke 2006;37:1583–633.[↩]
  8. Addo, J.; Ayerbe, L.; Mohan, K.M.; Crichton, S.; Sheldenkar, A.; Chen, R.; Wolfe, C.D.; McKevitt, C. Socioeconomic status and stroke: An updated review. Stroke 2012, 43, 1186–1191.[↩]
  9. Sandel, M.E.; Wang, H.; Terdiman, J.; Hoffman, J.M.; Ciol, M.A.; Sidney, S.; Quesenberry, C.; Lu, Q.; Chan, L. Disparities in stroke rehabilitation: Results of a study in an integrated health system in northern California. PM R 2009, 1, 29–40.[↩]
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