Social support and stroke risk: An epidemiological study of a population aged 25–64 years in Russia/Siberia (the WHO MONICA-psychosocial program)

Abstract

Objective: to determine the impact of social support on the risk of stroke in an open population aged 25–64 years in Russia/Siberia. Patients and methods. A random representative sample of a Novosibirsk population aged 25–64 years (657 men; mean age, 44.3±0.4 years; response rate, 82.1%; 689 women; mean age, 45.4±0.4 years; response rate, 72.5%) was examined within Screening III of the WHO MONICA-psychological program. The screening program included: registration of sociodemographic data and determination of social support (the index of close contacts (ICC) and the social network index (SNI). The prospective follow-up study period was 16 years. The study identified the following end-point: new-onset stroke cases. Results and discussion. The open population aged 25–64 years showed a low ICC in 62% of men and in 56.8% of women (χ2=22.603; df=2; p=0.0001) and a low SNI in 43.5% of men and in 33.9% of women (χ2=21.546; df=2; p=0.0001). During a 16-year follow-up, the risk of stroke in the people with a low ICC was 3.5 times higher for men (95% confidence interval (CI), 1.42–7.69; p<0.05), and that was 3.6 times higher for women (95% CI, 1.5–8.7; p<0.01). Over the same follow-up period, the risk of stroke in the patients having a low SNI was 3.4-fold higher for men (95% CI 1.28–5.46, p<0.001) and 2.3-fold higher for women (95% CI 1.18–4.49, p<0.05). Application of a multivariate model revealed an increase in the risk of stroke in people with a low level of social support: in men with an unfavorable family status, manual labor and in women with a low level of education. Conclusion. Social support is a protective risk factor for stroke in both men and women.