Factors associated with stroke in Bangladesh: a hospital-based case-control study

Stroke is a major public health challenge in Bangladesh, contributing substantially to morbidity and mortality. Identifying modifiable and non-modifiable determinants is essential for effective prevention strategies. This study aimed to identify factors independently associated with stroke among adults admitted to a tertiary hospital in Bangladesh. This hospital-based case–control study was conducted at Shaheed Suhrawardy Medical College Hospital, Dhaka, from July 2024 to July 2025. A total of 268 participants (134 incident stroke cases and 134 controls without stroke) were enrolled using purposive sampling. Incident cases were recruited within 72 h of symptom onset. Data were collected using a structured questionnaire and medical record review. Associations were assessed using chi-square tests and independent t-tests. Variables significant in bivariate analysis were entered into a multivariable logistic regression model to determine adjusted odds ratios (AORs) with 95% confidence intervals. The mean age of stroke patients was significantly higher than controls (63.8 ± 12.8 vs. 57.3 ± 11.7 years, p < 0.001). After adjustment, significant determinants of stroke included advancing age (AOR = 1.12, p = 0.049), higher body mass index (AOR = 2.59, p < 0.001), hypertension (AOR = 6.54, p < 0.001), dyslipidemia (AOR = 12.63, p < 0.001), current smoking (AOR = 8.18, p < 0.001), male sex (AOR = 2.31, p = 0.048), and family history of stroke (AOR = 2.98, p = 0.046). Diabetes, education, household income, and residence were not independently associated after adjustment. Dyslipidemia and smoking emerged as the strongest modifiable determinants of stroke. Strengthening lipid management, tobacco control, and hypertension screening programs may substantially reduce stroke burden in Bangladesh.