Lifestyle factors and risk of cerebral infarction.

857

522

on behalf of the German Stroke Data Bank CollaboratorsBackground and Purpose-Data on risk factors for etiologic subtypes of ischemic stroke are still scant. The aim of this study was to characterize stroke subtypes regarding risk factor profile, outcome, and current treatment strategies. Methods-We analyzed data from 5017 patients with acute ischemic stroke (42.4% women, aged 65.9Ϯ14.1 years) who were enrolled in a large multicenter hospital-based stroke data bank. Standardized data assessment and stroke subtype classification were used by all centers. Results-Sex and age distribution, major risk factors and comorbidities, recurrent stroke, treatment strategies, and outcome were all unevenly distributed among stroke subtypes (PϽ0.001, respectively). Cardioembolism, the most frequent etiology of stroke (25.6%), was particularly common in the elderly (those aged Ͼ70 years) and associated with an adverse outcome, a low rate of early stroke recurrence, and frequent use of thrombolytic therapy and intravenous anticoagulation. Large-artery atherosclerosis (20.9%), the most common cause of stroke in middle-aged patients (those aged 45 to 70 years), showed the highest male preponderance, highest rate of early stroke recurrence, and highest prevalence of previous transient ischemic attack, current smoking, and daily alcohol consumption among all subtypes. The highest prevalence of hypertension, diabetes mellitus, hypercholesterolemia, and obesity was found in small-vessel disease (20.5%), which, in turn, was associated with the lowest stroke severity and mortality. Conclusions-Our results foster the concept of ischemic stroke as a polyetiologic disease with marked differences between subtypes regarding risk factors and outcome. Therefore, studies involving risk factors of ischemic stroke should differentiate between etiologic stroke subtypes. (Stroke. 2001;32:2559-2566.)

Section: Discussionmentioning

confidence: 99%

Risk Factors, Outcome, and Treatment in Subtypes of Ischemic Stroke: The German Stroke Data Bank

Grau¹,

Weimar²,

Buggle³

et al. 2001

857

522

“…During recent years, obesity (including body fat distribution and waist-to-hip ratio) has received increased attention as a possible risk factor for stroke, but the data are inconsistent. 20,29,34 -38 In a nested case-control study in Norway, 29 subjects in the top quintile of BMI (Ͼ29.24) had the highest risk of ischemic stroke, and those in the second-lowest quintile of BMI (23.23 to 25.06) had the lowest risk, but the difference in risk between these groups was not significant. The estimated influence of a high BMI on the risk of stroke has been significant in some studies 36,39,40 but insignificant in others.…”

Section: Discussionmentioning

confidence: 99%

“…The estimated influence of a high BMI on the risk of stroke has been significant in some studies 36,39,40 but insignificant in others. 29,35,[41][42][43][44] The atherogenic effect of obesity has been suggested as a pathophysiologic mechanism responsible for the increased risk of cerebrovascular disease in overweight people. 45 Our findings of a significant association of BMI with the risk of ischemic stroke suggest that obesity may be a more potent risk factor for ischemic stroke than previously has been appreciated, although we were unable to adjust for serum lipid levels.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Ischemic Stroke in a Russian Community

Feigin¹,

Wiebers²,

Nikitin³

et al. 1998

Background and Purpose-This study was conducted to determine the risk factors for ischemic stroke in a defined Russian population. Methods-Our data are based on a population-based case-control study of 237 patients with first-ever ischemic stroke and 237 age-and sex-matched controls. Logistic regression methods for matched pairs were used to estimate the relative risk for the variables studied. Results-In a multivariate analysis, hypertension, left ventricular hypertrophy on electrocardiography, ischemic heart disease, mitral valve disease, current cigarette smoking, and high body mass index were significant and independent risk factors for ischemic stroke in this Russian community. Conclusions-The significant risk factors for ischemic stroke in Novosibirsk are similar to those from other populations and cohorts. This study, the first of stroke risk factors in Russia, has implications for clinical practice and the planning of stroke prevention in the population. (Stroke. 1998;29:34-39.)

“…There is increasing evidence that physical activity may also be negatively associated with the risk of stroke, [1][2][3][4][5][6][7][8][9][10][11] but only a few studies have examined physical activity and stroke in women, particularly among elderly women. [1][2][3][4]8,9,[12][13][14][15] Results of prospective studies among women have been divergent, showing no association, 1,14,16 increased risk only in the low-activity group, 2-4,12 and a negative dose-risk association between levels of physical activity and stroke morbidity and mortality. 8,9,15 Physical activity may have beneficial effects on biochemical (glucose intolerance, HDL cholesterol, fibrinolytic activity) and physiological (body mass index [BMI], blood pressure, pulse rate, vital capacity, O 2 uptake) factors.…”

mentioning

confidence: 99%

Physical Activity and Stroke Mortality in Women

Ellekjær

Holmen

Ellekjær

et al. 2000

Background and Purpose-Few studies have reported a protective effect of physical activity on stroke in women, particularly among elderly women. This study was conducted to examine the association between different levels of leisure-time physical activity and stroke mortality in a large prospective study of middle-aged and elderly women. Methods-We conducted a 10-year mortality follow-up of women aged Ն50 years, free from stroke at baseline (nϭ14 101), who participated in the Nord-Trøndelag Health Survey in Norway during 1984 -1986. Main outcome measures were relative risk of stroke mortality according to increasing levels of physical activity, with the least active group used as reference. Results-In groups aged 50 to 69, 70 to 79, and 80 to 101 years, the relative risk of dying decreased with increasing physical activity, after adjustment for potentially confounding factors. In groups aged 50 to 69 and 70 to 79 years, the most active women had an adjusted relative risk of 0.42 (95% CI, 0.24 to 0.75) and 0.56 (95% CI, 0.36 to 0.88), respectively. In the group aged 80 to 101 years, there was a consistent negative association with physical activity; the adjusted relative risk for the most active was 0.57 (95% CI, 0.30 to 1.09). Conclusions-Physical activity was associated with reduced risk of death from stroke in middle-aged and elderly women.This association persisted after we excluded individuals with prevalent cardiovascular and cerebrovascular disease at baseline and women who died during the first 2 years of follow-up. These observations strengthen the evidence that physical activity should be part of a primary prevention strategy against stroke in women. (Stroke. 2000;31:14-18.)