Enfermedad cerebrovascular en atahualpa: Prevalencia e incidencia

Translated title of the contribution: Cerebrovascular disease in atahualpa: Prevalence and incidence.

Oscar H.Del Brutto, Victor J.Del Brutto, Mauricio Zambrano, Julio Lama

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Stroke burden is on the rise in rural regions of South America. We evaluated prevalence, pattern of subtypes and pathogenetic mechanisms underlying stroke in Atahualpa. In a three-phase epidemiologic study, suspected cases were detected by a door-to-door survey. Then, neurologists evaluated suspected cases and randomly selected negative persons, and confirmed patients underwent complementary exams. We found 20 stroke patients among 642 persons aged. ≥40 years. Stroke prevalence was 31.15% that increased with age. Hypertensive arteriolopathy was the most likely mechanism underlying strokes (55% patients). Extracranial atherosclerotic lesions or cardiac sources of emboli were not found in any case. Comparison of our findings with a previous survey performed in the same village showed an alarming increase in stroke prevalence (from 14.08% in 2003 to 31.15% in 2012, p=0.03). Thereafter, we conducted an incidence study. For this, first-ever strokes occurring over four years were identified from yearly door-to-door surveys and other overlapping sources. Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48±0.95 years). Stroke incidence rate was 2.97 per 100 person-years of follow-up (95% C.I.:, which increased to 4.77 (95% C.I.: when only persons aged.57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% C.I.: and severe edentulism (IRR: 5.06; 95% C.I.: were the factors independently increasing stroke incidence. Stroke incidence in Atahualpa is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independent ly predicting incident strokes.

Translated title of the contributionCerebrovascular disease in atahualpa: Prevalence and incidence.
Original languageSpanish
Pages (from-to)158-163
Number of pages6
JournalRevista Ecuatoriana de Neurologia
Issue number2
StatePublished - 2017
Externally publishedYes


  • Atahualpa
  • Cerebral Infarction
  • Ecuador
  • Epidemiology
  • Intracranial Hemorrhage
  • Population-Based Study

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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