Assessing the individual risk of stroke in caregivers of patients with stroke

Genetic factors influence the risk of developing stroke. Still, it is unclear whether this risk is intrinsically high in certain people or if nongenetic factors explain it entirely.

Objective

To compare the risk of stroke in kin and nonkin caregivers.

Methods

In a cross-sectional study using the Stroke Riskometer app (AUT Ventures Limited, Auckland, AUK, New Zealand), we determined the 5- and 10-year stroke risk (SR) among caregivers of stroke inpatients. The degree of kinship was rated with a score ranging from 0 to 50 points.

Results

We studied 278 caregivers (69.4% of them female) with a mean age of 47.5 ± 14.2 years. Kin caregivers represented 70.1% of the sample, and 49.6% of them were offspring. The median SR at 5 years was of 2.1 (range: 0.35–17.3) versus 1.73 (range: 0.04–29.9), and of 4.0 (range: 0.45–38.6) versus 2.94 (range: 0.05–59.35) at 10 years for the nonkin and kin caregivers respectively. In linear logistic regression controlled for the age of the caregivers, adding the kinship score did not increase the overall variability of the model for the risk at 5 years (R²= 0.271; p= 0.858) nor the risk at 10 years (R²= 0.376; p= 0.78).

Conclusion

Caregivers of stroke patients carry a high SR regardless of their degree of kinship.

Keywords
Stroke; Risk Factors; Caregivers

Variable		Any kinship, n= 195	No kinship, n= 83	p value
Female sex: n (%)		137 (70.3)	56 (67.5)	0.642^* * Chi-squared test.
Age in years: median (minimum–maximum)		46 (20–85)	52 (20–80)	< 0.001^ Mann-Whitney U test.
Body mass index in Kg/m²: median (minimum–maximum)		27.3 (14.8–42.2)	26.9 (17.9–44.1)	0.328^ Mann-Whitney U test.
Obesity: n (%)		140 (71.8)	54 (65.1)	0.256^* * Chi-squared test.
Shared household: n (%)		57 (29.2)	67 (80.7)	< 0.001^* * Chi-squared test.
Shared diet: n (%)		99 (50.8)	71 (85.5)	< 0.001^* * Chi-squared test.
Stroke risk factors: n (%)	Smoking	65 (33.3)	28 (33.7)	0.936^* * Chi-squared test.
	Alcohol intake	8 (4.1)	2 (2.4)	0.491^* * Chi-squared test.
	Hypertension	54 (27.7)	25 (30.1)	0.683^* * Chi-squared test.
	Diabetes mellitus	33 (16.9)	18 (21.7)	0.366^* * Chi-squared test.
	Cardiovascular disease	8(4.1)	5 (6.0)	0.688^* * Chi-squared test.
	Healthy diet	69 (35.4)	34 (41.0)	0.381^* * Chi-squared test.
	Exercise	70 (40.0)	34 (41.0)	0.879^* * Chi-squared test.
	Emotional stress	138 (70.8)	61(73.5)	0.651^* * Chi-squared test.

Variable	No kinship, n= 83	Any kinship, n= 195			p value
5-year risk: median (minimum-maximum)	2.1 (0.35–17.3)	1.73 (0.04–29.9)			0.055^* * Mann-Whitney U test.
		12.5%; n= 3	25%; n= 6	50%; n= 186
		2.8 (0.55–4.56)	2.2 (0.64–5.6)	1.7 (0.04–29.9)	0.300^ Independent samples Kruskal-Wallis test.
10-year risk: median (minimum-maximum)	4.0 (0.45–38.6)	2.94 (0.05–59.35)			0.047^* * Mann-Whitney U test.
		12.5%; n= 3	25%; n= 6	50%; n= 186
		4.3 (0.93–7.74)	3.2 (0.86–13.1)	2.9 (0.05–59.4)	0.252^ Independent samples Kruskal-Wallis test.

Variable		Adjusted R²	∆R²	β	95% confidence interval	p value
5-year risk	Model 1	0.273	0.276
	Age			0.130	0.105–0.155	< 0.001
	Model 2	0.271	0.000
	Kinship score			- 0.001	-0.017–0.014	0.856
10-year risk	Model 1	0.378	0.381
	Age			0.343	0.291–0.395	< 0.001
	Model 2	0.376	0.000
	Kinship score			0.005	-0.028–0.038	0.777

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[1] Address for correspondence Juan Manuel Marquez-Romero (email: scint1st@gmail.com)