Association between Ramadan Fasting and cerebrovascular diseases


  • Ihsan K. AlShimmery Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Abdullah Faky Yazdeen Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Mutaz Fadhil Hummadi Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Srood N Jarjees Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Namir G. Al-Tawil Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.



Ramadan, Fasting, Stroke, Summer season


Background and objective: Cerebrovascular diseases are attacks of sudden neurological deficits (motor, sensory or cerebellar). There are a lot of risk factors for stroke like age, diabetes, hypertension, smoking, hyperlipidemia, cardiac diseases and others. This study aimed to show if there is increasing rate of cerebrovascular events during Ramadan in   relation to fasting in our city during the summer season.

Methods: This case-control study was carried out in Rizgary Teaching Hospital, Erbil- Iraq from 1st of August to 30th of August 2011. Patients were included in this study if they were middle aged and elderly patients having clinical and radiological features of stroke, another group of in-patients was selected as a control group. Chi square test and logistic regression analyses were used to show the association between stroke and fasting.

Results: A sample of 60 patients and 60 control cases were included in this study. Fasting was significant risk factor for stroke in our studied sample, 66.7% of the cases were fasting compared with 40% of the control group (P = 0.03). Hyperlipidemia and history of ischemic heart disease found also to be associated with stroke (P = 0.017 and 0.011, respectively). Logistic regression analysis showed that only fasting and hypercholesterolemia were independent risks factors in causing stroke in our studied sample.

Conclusion: In Erbil, where the summer is too hot and the daytime (fasting hours) is long, fasting during Ramadan was found to be an independent risk factor for stroke, and specifically ischemic stroke.


Metrics Loading ...


Bener A, Hamad A, Fares A, Al-Sayed HM, Al-Suwaidi J. Is there any effect of Ramadan fasting on stroke incidence? Singapore Med J 2006; 47(5):404-8.

Omouglu S, Temuzhan A, Pesuncu E, Tandouan U, Ozbakir S. Effects of Ramadan Fasting on Stroke. Turk J Med Sci 2003; 33:237-41.

Al Suwaidi J, Bener A, Al Binali H, Numan MT. Does hospitalization for congestive heart failure occur more frequently in Ramadan: a population based study (1991 - 2001). Int J Cardiol 2004; 96:217-21.

Akhan G, Kutluhan S, Koyuncuoglu HR. Is there any change of stroke incidence during Ramadan. Acta Neurol Scand 2000; 101:259-61.

Bener A, Galadari S, Gillett M, Osman N, Al-Taneiji H. Fasting during the holy month of Ramadan does not change the composition of breast milk. Nutrition Research 2001; 21:859-64.

Aslam M, Assad A. Drug regimens and fasting during Ramadan. A survey in Kuwait. Public Health 1986; 100:49-53.

Chitsaz A, Ashtari F, Sadeghian M, Farajzadegan Z. The relation between Ramadan fasting and stroke incidence over a two year study. Journal of Isfahan Medical School, Special Issue on Health Promotion 2009; 26:605-13.

Ince B, Turgut N, Celik Y, Denktas H. Effect of Ramadan on occurrences and prognosis of stroke. J Turkish Association Neurology 1997; 3:68.

Kutluhan S, Sandilkci Y, Aytekin S. The Relationship of Ramadan with Cerebrovascular Diseases. J Vakif Gureba Hospitals 1996; 21:269-74.

Saadatnia M, Zare M, Fatehi F, Ahmadi A. The effect of fasting on cerebral venous and dural sinus thrombosis. Neurol Res 2009; 31(8):794-8.

Sacco RL. Vascular disease: Pathogenesis, Classification and Epidemiology of Cerebrovascular disease. In: Rowland LP editor. Merrit’s Neurology. 11th ed. Philadelphia (PA): Lippincott Williams and Wilkins; 2005. P. 275-91.

Temizhan A, Donderici O, Oguz D, Demirbas B. Is there any effect of Ramadan fasting on acute coronary heart disease events. Int J Cardiol 1999; 70:149-53.

Young JB, Landsberg L. Impaired Suppression of Sympathetic Activity during Fasting in the Gold Thioglucose-treated Mouse. J Clin Invest 1980; 65(5):1086-94.

Stokholm Kh, Berum L, Astrup A. Cadiac Contractiliy, Central hemodynamics and Blood Pressure during Semi starvation. Clin Physiol 1991; 11:513-23.

Cohen J, Fadul C, Jenkyn L, Ward T. Disorders of the Nervous System-Reeves & Swenson. 2nd ed. Dartmouth Medical School: Reeves A G; 2009.




How to Cite

AlShimmery, I. K., Yazdeen, A. F., Hummadi, M. F., Jarjees, S. N., & Al-Tawil, N. G. (2017). Association between Ramadan Fasting and cerebrovascular diseases. Zanco Journal of Medical Sciences (Zanco J Med Sci), 21(3), 1853–1858.



Original Articles