Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Abstract

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m2). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.

Perfil nutricional de pacientes acometidos de AVC atendidos em um hospital universitário no nordeste brasileiro

“…Além disso, o baixo peso, o excesso de peso e a obesidade foram associados a maior risco de AVC hemorrágico em homens, contudo, a relação AVCmortalidade é mais explorada em relação ao IMC, do que a CB. 18,19 Os valores obtidos de PCR (Proteína C Reativa) dos pacientes na tabela 3, demonstram que a maioria dos enfermos está com risco cardiovascular elevado. Um estudo demonstrou que níveis plasmáticos elevados de proteína C reativa ultrassensível (PCR-us) na admissão estão associados com deterioração neurológica e piora no desfecho de pacientes com AVC isquêmico.…”

Body mass index and early outcomes after carotid endarterectomy

“…As already stated, obesity is considered a risk factor for many diseases, including cardiovascular and cerebrovascular diseases [ 13 – 16 ]. It is also found that the risk of perioperative mortality is increased among obese patients undergoing vascular surgery [ 17 , 18 ].…”

Body mass index has a non-linear association with three-month outcomes in men with acute ischemic stroke: An analysis based on data from a prospective cohort study

“…There have been many findings in the past suggesting that elevated BMI is associated with a higher risk of ischemic stroke (36)(37)(38)(39). However, the relationship between BMI and the prognosis of stroke patients is uncertain and controversial.…”