Cardiovascular diseases including stroke are of increasing concern as the leading cause of mortality in low-middle income countries. Opium addiction is an independent risk factor for Ischemic stroke. The main objective of this study is to evaluate associations between opium use and risk of stroke mortality in the GCS
Data were obtained from the GCS, a prospective cohort study in North Eastern Iran encompassing 50,045 people. Participants were randomly selected From Gonbad City by systematic clustering based on household number and through temporary recruitment centers in health houses of selected villages. The GCS study population encompasses 29026 (58) women, 21019 (42) Men, Ages 40–75 years old, 40036 (80) rural residents from 326 villages, and 10009 (20) urban residents from Gonbad city. People who were unwilling to participate at any stage of the study, temporary residents, diagnosis of upper gastrointestinal cancer at baseline, diagnosis of cerebrovascular or cardiovascular diseases at baseline and those previously treated with polypills were excluded from this study. After application of exclusion criteria 38692 eligible participants were included in the study population. Participant information was assessed annually since baseline follow up in 2004 to 2008, with over 99% success follow-up rate. Occurrence of stroke mortality was assessed by reviewing medical records and performing verbal autopsies, and coded based on ICD-10 codes. Information on opium use was obtained from participant interviews and questionnaires. Hazard ratios (HR) of stroke mortality for opium use were estimated together with 95% confidence intervals (CI) using Cox proportional hazard models, after adjustment for
6381 (16.5%) reported ever using opium 716 (186 opium users, 530 never opium users) deaths from stroke occurred Unadjusted and adjusted HR for opium use were 1.95 (95% CI=1.65–2.30), and 1.43 (95%CI=1.19–1.72), respectively. mortality compared to never users
relationships and analysis of incident stroke events as the main outcome.
