Risk Factors Predisposing to Stroke in an Elderly Chinese Population – A Longitudinal Study

Woo, Jean; Lau, E. M. C.

doi:10.1159/000110762

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…Table 1 provides details of the included studies 2223 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 Of these 84 studies, 34 (40%) reported on all-male cohorts, six (7%) reported on women only, and 44 (52%) included both men and women.…”

Section: Resultsmentioning

confidence: 99%

Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

Ronksley

Brien

Turner

et al. 2011

BMJ

1,315

936

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Objective To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes. Design Systematic review and meta-analysis. Inclusion criteria Prospective cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Studies reviewed Of 4235 studies reviewed for eligibility, quality, and data extraction, 84 were included in the final analysis. Results The pooled adjusted relative risks for alcohol drinkers relative to non-drinkers in random effects models for the outcomes of interest were 0.75 (95% confidence interval 0.70 to 0.80) for cardiovascular disease mortality (21 studies), 0.71 (0.66 to 0.77) for incident coronary heart disease (29 studies), 0.75 (0.68 to 0.81) for coronary heart disease mortality (31 studies), 0.98 (0.91 to 1.06) for incident stroke (17 studies), and 1.06 (0.91 to 1.23) for stroke mortality (10 studies). Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1-2 drinks a day, but for stroke mortality it occurred with ≤1 drink per day. Secondary analysis of mortality from all causes showed lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)). Conclusions Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.

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Section: Resultsmentioning

confidence: 99%

Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

Ronksley

Brien

Turner

et al. 2011

BMJ

1,315

936

View full text Add to dashboard Cite

show abstract

“…After excluding patients in whom information on aspirin use was not available (enrolled before 1 December 1996), use of aspirin was not included as a predictor for stroke (P ϭ 0.6890). Second, although atrial fibrillation is a risk factor for stroke (24), it has been included in some (25) but not all stroke risk equations (6,14). We have not recorded this parameter in our present dataset.…”

Section: Discussionmentioning

confidence: 95%

Development and Validation of Stroke Risk Equation for Hong Kong Chinese Patients With Type 2 Diabetes

et al. 2007

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OBJECTIVE -We sought to develop stroke risk equations for Chinese patients with type 2 diabetes in Hong Kong. RESEARCH DESIGN AND METHODS -A total of 7,209Hong Kong Chinese type 2 diabetic patients without a history of stroke at baseline were analyzed. The data were randomly and evenly divided into the training subsample and the test subsample. In the training subsample, stepwise Cox models were used to develop the risk equation. Validation of the U.K. Prospective Diabetes Study (UKPDS) stroke risk engine and the current stroke equation was performed in the test dataset. The life-table method was used to check calibration, and the area under the receiver operating characteristic curve (aROC) was used to check discrimination.RESULTS -A total of 372 patients developed incident stroke during a median of 5.37 years (interquartile range 2.88 -7.78) of follow-up. Age, A1C, spot urine albumin-to-creatinine ratio (ACR), and history of coronary heart disease (CHD) were independent predictors. The performance of the UKPDS stroke engine was suboptimal in our cohort. The newly developed risk equation defined by these four predictors had adequate performance in the test subsample. The predicted stroke-free probability by the current equation was within the 95% CI of the observed probability. The aROC was 0.77 for predicting stroke within 5 years. The risk score was computed as follows: 0.0634 ϫ age (years) ϩ 0.0897 ϫ A1C ϩ 0.5314 ϫ log 10 (ACR) (mg/mmol) ϩ 0.5636 ϫ history of CHD (1 if yes). The 5-year stroke probability can be calculated by: 1 Ϫ 0.9707 EXP (Risk Score Ϫ 4.5674) .CONCLUSIONS -Although the risk equation performed reasonably well in Chinese type 2 diabetic patients, external validation is required in other populations. Diabetes Care 30:65-70, 2007S troke is among the most common causes of death worldwide (1). Chinese individuals have a higher incidence of stroke and related mortality than Caucasians, as shown in the World Health Organization MONICA project (2). Diabetic patients have a two-to fivefold increased risk of stroke, in part due to interactions between multiple risk factors (3). The Framingham Study (4) and U.K. Prospective Diabetes Study (UKPDS) (5) have developed risk equations based on data collected from the Caucasian community and diabetic patients. Although a stroke risk equation has been developed in a small cohort of Chinese men recruited from a workforce (6), there is currently no risk equation applicable to Chinese individuals with diabetes, despite this number being projected to 42.3 million by 2030 (7). In this study, we validate and develop stroke risk equations to predict first stroke in Chinese type 2 diabetic patients based on data from the Hong Kong Diabetes Registry. RESEARCH DESIGN AND METHODS-Since 1995, all newly referred diabetic patients to the Prince of Wales Hospital in Hong Kong underwent comprehensive assessments of complications and risk factors based on the European DiabCare protocol (7a). Patients with hospital admissions within 6 -8 weeks before assessment accounted for...

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“…(1) Because of a small sample size, we did not make a distinction among haemorrhage stroke, ischemic stroke and embolic stroke. Atrial fibrillation, an important risk factor for stroke 45, 46, was also not documented in this database. (2) Cross‐checking of HA computer system database and the death registry showed that our hospital admission database captured all deaths recorded in the death registry.…”

Section: Discussionmentioning

confidence: 99%

Effects of chronic hyperglycaemia on incident stroke in Hong Kong Chinese patients with type 2 diabetes

Yang

Kong

et al. 2007

Diabetes Metabolism Res

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Risk Factors Predisposing to Stroke in an Elderly Chinese Population – A Longitudinal Study

Cited by 11 publications

References 8 publications

Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

Development and Validation of Stroke Risk Equation for Hong Kong Chinese Patients With Type 2 Diabetes

Effects of chronic hyperglycaemia on incident stroke in Hong Kong Chinese patients with type 2 diabetes

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