Antecedent sedative use is independently associated with stroke occurrence among west Africans: Evidence from the SIREN case-control study

Abstract

Several factors have been independently associated with stroke occurrence globally. However, the association between sedative use and stroke risk is yet to be established in West Africa. To assess the association between sedatives and stroke among West Africans. Adults aged ≥18 years with confirmed stroke as well as age- and sex-matched controls were enrolled into the Stroke Investigative Research and Education Network (SIREN) study. Sedative use was determined by retrospective assessment on the use of any type of sedative in the preceding year while stroke was confirmed with brain scan and clinical features. Univariate and multivariate analyses, using logistic regressions, were performed to establish associations between sedative use and stroke while adjusting for ither stroke risk factors. A total of 7104 subjects (3553 stroke cases and 3551 stroke-free controls participated in this study. The mean age was 60.9 ± 0.78 among cases and 59.8 ± 11.44 years among controls ( p < 0.029). History of sedative use was more common in cases (7.7 %) compared to controls (4.3 %; p < 0.001) . After adjusting for age, income >$100, history of hypertension, diabetes, dyslipidaemia, tobacco & alcohol use, physical inactivity, green leafy vegetable and meat consumption, sedative use was independently associated with stroke risk (aOR: 1.41; 95 %CI: 1.01–1.96; p < 0.041). Sedative use was associated with higher odds of stroke among adults aged ≥50 years (aOR: 1.53; 95 %CI: 1.28–2.04; p < 0.019). Sedative use was independently associated with stroke risk among adults in West Africa. Its use requires further exploration and prospective study to address the emerging association with stroke occurrence. • Use of other illicit substances including alcohol, tobacco and sedatives was reported among cases and control subjects involved in this study • The prevalence of sedative use by adults in West Africa, has increased from 3.4 % in 2007 to 7.7 % as observed in our study • The prevalence of antecedent sedative use among stroke cases was 7.7 % (272/3553) compared to 4.3 % among stroke-free participants. Sedative use was associated with higher odds of stroke among adults aged ≥50 years, an age group required to drive the economic profile of West Africa. • After adjusting for age, income >$100, history of hypertension, diabetes, dyslipidaemia, tobacco & alcohol use, physical inactivity, green leafy vegetable and meat consumption, sedative use was independently associated with stroke risk • Further exploration and prospective studies are required to further confirm and characterise the emerging association with stroke occurrence.