{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:36:24Z","timestamp":1776087384105,"version":"3.50.1"},"reference-count":18,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"abstract":"<jats:p>Introduction: Stroke causes significant death and disability, with urban-rural disparities in healthcare and limited studies in India, despite its rural majority of 70%. The post hoc study aimed to explore differences in stroke profiles, risk factors, and outcomes between urban and rural participants using data from the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial. Methods: The SPRINT INDIA trial was a multi-center randomized clinical trial across 31 Indian sites. Data were collected between April 28, 2018, and November 30, 2021. Index stroke patients, aged 18 and older, presenting within 2 days to 3 months of symptom onset, were randomized using a centralized web-based system into intervention or control groups. The intervention included SMS, videos, and an interactive educational workbook for secondary stroke prevention in 11 Indian languages. Baseline data captured in a case report form included participants\u2019 urban or rural locations. The primary outcome was a composite endpoint that included recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), and all-cause mortality within 1 year after randomization. The trial is registered by &lt;ext-link ext-link-type=\"uri\" xlink:href=\"http:\/\/Clinicaltrials.gov\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\"&gt;Clinicaltrials.gov&lt;\/ext-link&gt; (NCT03228979) and Clinical Trials Registry-India (CTRI\/2017\/09\/009600). Results: The trial enrolled 4,298 sub-acute stroke patients, out of which 3,038 (70.68%) were followed up, of which 1,620 (53.32%) were urban and 1,418 (46.68%) were rural. The primary composite outcome (recurrent stroke, high-risk TIA, ACS, and mortality) was higher in urban areas compared to rural areas (61 [3.8%] vs. 34 [2.4%]; p = 0.018) at 1-year follow-up. All cases of high-risk TIA occurred in urban participants (p &lt; 0.001). Urban participants were more educated (795 [49.1%] vs. rural 394 [27.8%]; p &lt; 0.001), with higher rates of dyslipidemia (335 [20.7%] vs. 247 [17.4%]; p = 0.023), and higher body mass index (25.17 \u00b1 4.31 vs. 24.76 \u00b1 4.23; p = 0.008). Behavioral risk factors of alcohol intake and smoking tobacco were higher in rural patients compared to urban patients (65 [4.6%] vs. 73 [4.5%]; p &lt; 0.001 and 59 [4.2%] vs. 65 [4.0%]; p &lt; 0.001, respectively). Conclusion: Urban patients show higher stroke recurrence and lifestyle-related conditions, while rural patients face more behavioral risks like smoking and alcohol use. To address these disparities, requires targeted interventions; urban patients would benefit from lifestyle-focused programs, such as dietary improvements and stress management. For rural patients, programs should focus on reducing behavioral risks like smoking and alcohol use through community-based education and accessible cessation support services.<\/jats:p>","DOI":"10.1159\/000545675","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T12:01:36Z","timestamp":1744804896000},"page":"29-39","source":"Crossref","is-referenced-by-count":1,"title":["Comparing Stroke Profiles and Outcomes between Urban and Rural India: A Secondary Analysis of the SPRINT INDIA Trial"],"prefix":"10.1159","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-9781","authenticated-orcid":false,"given":"Shweta Jain","family":"Verma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arya Devi","family":"Karuthedathu mana Sanal Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-622X","authenticated-orcid":false,"given":"Deepti","family":"Arora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2451-8029","authenticated-orcid":false,"given":"Aneesh","family":"Dhasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-8275","authenticated-orcid":false,"given":"Padmavathyamma Narayanapillai","family":"Sylaja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dheeraj","family":"Khurana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamidimukkala","family":"Vijaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biman Kanti","family":"Ray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Nambiar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjith","family":"Aaron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav Kumar","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparna R.","family":"Pai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somasundaram","family":"Kumaravelu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yerasu Muralidhar","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9866-2894","authenticated-orcid":false,"given":"Sunil","family":"Narayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nomal Chandra","family":"Borah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupjyoti","family":"Das","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Girish Baburao","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Huded","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Padma","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7662-3202","authenticated-orcid":false,"given":"Rohit","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawan Kumar","family":"Ojha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-2619","authenticated-orcid":false,"given":"Jayanta","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherly Mary","family":"Abraham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Vaishnav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvind","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Pathak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev Kumar","family":"Bhoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudhir","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sulena","family":"Sulena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aralikatte Onkarappa","family":"Saroja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neetu","family":"Ramrakhiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhusudhan Byadarahalli","family":"Kempegowda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shankar Prasad","family":"Gorthi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-2882","authenticated-orcid":false,"given":"Mahesh Pundlik","family":"Kate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9196-3130","authenticated-orcid":false,"given":"Ivy Anne","family":"Sebastian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meenakshi","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupinder","family":"Dhaliwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Huilgol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-1968","authenticated-orcid":false,"given":"Jeyaraj Durai","family":"Pandian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00164-9"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/17474930211027834"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00544-7"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106661"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/1747493019895653"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2011.00456.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2023.100308"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2018.12.021"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.117339"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-43977-z"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.4103\/0976-7800.179166"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.mjafi.2019.12.005"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076005"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009802"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.dialog.2023.100109"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0120902"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-409"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1177\/23969873231192291"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/ced\/article-pdf\/doi\/10.1159\/000545675\/4365994\/000545675.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T17:01:04Z","timestamp":1768237264000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000545675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,16]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,12]]}},"URL":"https:\/\/doi.org\/10.1159\/000545675","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28788107","asserted-by":"subject"}]},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,16]]}}}