Modifiable and Non-Modifiable Factors Associated With a History of Stroke in the Working-Age Population of Southern Kazakhstan: A Population-Based Screening Study

Background. Stroke remains a major cause of mortality and long-term disability worldwide. A substantial proportion of stroke burden is attributable to modifiable cardiovascular, metabolic, and lifestyle-related risk factors. However, population-based data on the distribution of these factors among working-age adults in Southern Kazakhstan remain limited.Aim: to assess the prevalence and distribution of major modifiable and non-modifiable cerebrovascular risk factors and to identify factors independently associated with a history of stroke among working-age adults in Southern Kazakhstan.Materials and methods. A cross-sectional population-based screening study included 2,357 working-age adults from Southern Kazakhstan. A history of stroke was identified in 212 participants (9.0%). The mean age of participants was 53.0 ± 9.0 years, and 1,367 (58.0%) were men. Data were collected using standardized questionnaires and clinical assessments, including evaluation of cardiovascular and cerebrovascular risk factors, anthropometric measurements, duplex ultrasonography of the extracranial brachiocephalic arteries, and assessment of psychosocial stress. Multivariable logistic regression analysis was performed to identify factors independently associated with a history of stroke.Results. Cerebrovascular disease was identified in 35.0% of participants (n = 825), while a history of stroke was identified in 9.0% (n = 212). The most frequently observed factors and vascular conditions were alcohol consumption (72.9%, n = 1,718), arterial hypertension (57.9%, n = 1,365), brachiocephalic artery stenosis ≥50% (45.6%, n = 1,075), coronary artery disease (41.0%), physical inactivity (42.4%), current smoking (25.0%, n = 589), high psychosocial stress (21.6%, n = 510), type 2 diabetes mellitus (13.2%, n = 310), and obesity (26.7%). Overweight or obesity was present in 81.2% of participants. In the multivariable logistic regression model, older age (adjusted OR [aOR] 1.07 per year, 95% CI 1.05–1.09; p < 0.001), arterial hypertension (aOR 3.38, 95% CI 2.16–5.30; p < 0.001), high psychosocial stress (aOR 1.74, 95% CI 1.25–2.43; p = 0.001), and type 2 diabetes mellitus (aOR 1.59, 95% CI 1.08–2.34; p = 0.019) were independently associated with a history of stroke. Brachiocephalic artery stenosis ≥50%, current smoking, alcohol consumption, and male sex were not independently associated with previous stroke after adjustment.Conclusion. Working-age adults in Southern Kazakhstan demonstrate a substantial burden of cardiovascular and cerebrovascular risk factors, particularly alcohol consumption, excess body weight, arterial hypertension, and other modifiable risk factors. Older age, arterial hypertension, high psychosocial stress, and type 2 diabetes mellitus were independently associated with a history of stroke. These findings support strengthening systematic cardiovascular risk assessment and targeted preventive interventions within primary healthcare, with particular emphasis on blood pressure control, metabolic risk management, tobacco cessation, reduction of harmful alcohol consumption, and lifestyle modification.