Shaikh, Raheela Begum (2022) Stroke in South Asians in the United Kingdom : a multimethod study focussing on Bangladeshi. PhD thesis, University of Warwick.
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Abstract
Background: Stroke is the fourth leading cause of death and a major cause of disability in the UK. Ethnicity is one of the independent predictors of stroke.
Aim: To explore stroke in the South Asian population in the UK, with a focus on Bangladeshis.
Methods: Multi-method study, comprising a systematic review of the epidemiology of stroke in South Asians in the UK and four primary studies:
(i) Secondary data analysis of the Wandsworth Heart and Stroke Study (WHSS) in South London, exploring risk factors associated with stroke in the Bangladeshi population.
(ii) Freedom of Information (FOI) request of Birmingham hospitals to explore stroke admissions by ethnic group.
(iii) Case-note analysis of patients admitted with stroke at a Birmingham hospital, exploring risk factors by ethnic group (White Europeans, Indian, Pakistani, Bangladeshi).
(iv) Audit of the acute stroke pathway at a Birmingham hospital to explore the management of stroke by ethnic group (as above).
Results: The systematic review identified a higher mortality rate from stroke in the South Asian population in the UK. The WHSS showed that risk factors, such as the prevalence of hypertension and diabetes, are highest amongst South Asians compared with White Europeans, with a tendency for the highest risk amongst the Bangladeshi population.
The FOI data showed that the average age of admission for stroke was significantly lower for South Asians compared with White British, being most marked for the Bangladeshi population.
The case-note analysis of stroke patients identified that Bangladeshis had the highest proportion with a past medical history of infection and low post-stroke blood pressure; had the highest proportion with haemorrhagic stroke; and the highest mortality rate. Atrial fibrillation was significantly more common in White Europeans.
No significant differences were recorded in the stroke treatment pathway by ethnicity.
Conclusion: Even though the sample sizes are small, ethnic differences in stroke risk factors have been found which need further exploration, particularly amongst the Bangladeshi population.
A culturally sensitive targeted health promotion programme could potentially reduce the risk of stroke in the Bangladeshi population.
| Item Type: | Thesis [via Doctoral College] (PhD) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
| Library of Congress Subject Headings (LCSH): | Cerebrovascular disease -- Patients -- Great Britain, Cerebrovascular disease -- Epidemiology, Bangladeshis -- Health and hygiene -- Great Britain |
| Official Date: | July 2022 |
| Dates: | Date Event July 2022 UNSPECIFIED |
| Institution: | University of Warwick |
| Theses Department: | Warwick Medical School |
| Thesis Type: | PhD |
| Publication Status: | Unpublished |
| Supervisor(s)/Advisor: | Cappuccio, Francesco ; Robertson, Wendy |
| Format of File: | |
| Extent: | xvii, 333 pages : illustrations |
| Language: | eng |
| URI: | https://wrap.warwick.ac.uk/173397/ |
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