Comparison of stroke among Christians and Muslims in Thrace, Greece.

Abstract

INTRODUCTION: Background and purpose: Previous studies have demonstrated significant racial differences in incidence, age of onset, outcome and subsequent risk factors of stroke. However, there is scarce evidence available for Muslim populations worldwide. Xanthi region, a mainly rural and remote area in northern Greece, which is characterized by a mixed Christian/Muslim population, is considered appropriate for further studies in this area. METHODS: A prospective clinical study, based on a cohort of 530 consecutive unselected patients, 366 Christians and 164 Muslims, who had their first documented episode of stroke between 1998 and 2002. Chi-square and Fisher's exact test for comparison between discrete parameters, Student's t-test for comparison between quantitative parameters and Pearson's r for correlations (along with Bonferroni's adjustment) were used. A multiple logistic regression model was performed for evaluation of religion and gender as independent predictors of type of stroke. RESULTS: Muslims, when compared with Christians: (1) present with ischemic stroke less often (p = 0.049); (2) suffer from stroke at a younger age (67.26 +/- 9.77 vs 71.43 +/- 10.88 years; p < 0.001); (3) show a significantly lower incidence rate (87.2 vs 173.9 cases/100,000 person*years; RR 1.994; p < 0.001); (4) have lower rates of diabetes (p = 0.019) and atrial fibrillation (p < 0.001) and (5) present similar mortality (p = 0.347). CONCLUSIONS: Lower diabetes and atrial fibrillation rates among the Muslims of Thrace, Greece, might account for their low incidence of stroke. The contribution of culture-related habits (diet, occupation) remains to be investigated in further studies.