Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study

15 p.

Autores:
O’Donnell, Martin J.
Chin, Siu Lim
Rangarajan, Sumathy
Xavier, Denis
Liu, Lisheng
Zhang, Hongye
Rao Melacini, Purnima
Zhang, Xiaohe
Pais, Prem
Agapay, Steven
Lopez-Jaramillo, Patricio
Damasceno, Albertino
Langhorne, Peter
McQueen, Matthew J.
Rosengren, Annika
Dehghan, Mahshid
Hankey, Graeme J.
Dans, Antonio
ElSayed, Ahmed
Avezum, Alvaro
Mondo, Charles
Diener, Hans Christoph
Ryglewicz, Danuta
Czlonkowska, Anna
Pogosova, Nana
Weimar, Christian
Iqbal, Romaina
Diaz, Rafael
Yusoff, Khalid
Yusufali, Afzalhussein
Oguz, Aytekin
Wang, Xingyu
Penaherrera, Ernesto
Lanas, Fernando
Ogah, Okechukwu S.
Ogunniyi, Adesola
Iversen, Helle K.
Malaga, German
Rumboldt, Zvonko
Oveisgharan, Shahram
Hussain, Fawaz Al
Magazi, Daliwonga
Nilanont, Yongchai
Ferguson, John
Paré, Guillaume
Yusuf, Salim
INTERSTROKE investigators
Tipo de recurso:
Article of journal
Fecha de publicación:
2016
Institución:
Universidad de Santander
Repositorio:
Repositorio Universidad de Santander
Idioma:
eng
OAI Identifier:
oai:repositorio.udes.edu.co:001/3452
Acceso en línea:
https://repositorio.udes.edu.co/handle/001/3452
Palabra clave:
Risk
Acute stroke
Rights
openAccess
License
Derechos Reservados - The Lancet, 2016
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dc.title.eng.fl_str_mv Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
title Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
spellingShingle Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
Risk
Acute stroke
title_short Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
title_full Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
title_fullStr Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
title_full_unstemmed Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
title_sort Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control study
dc.creator.fl_str_mv O’Donnell, Martin J.
Chin, Siu Lim
Rangarajan, Sumathy
Xavier, Denis
Liu, Lisheng
Zhang, Hongye
Rao Melacini, Purnima
Zhang, Xiaohe
Pais, Prem
Agapay, Steven
Lopez-Jaramillo, Patricio
Damasceno, Albertino
Langhorne, Peter
McQueen, Matthew J.
Rosengren, Annika
Dehghan, Mahshid
Hankey, Graeme J.
Dans, Antonio
ElSayed, Ahmed
Avezum, Alvaro
Mondo, Charles
Diener, Hans Christoph
Ryglewicz, Danuta
Czlonkowska, Anna
Pogosova, Nana
Weimar, Christian
Iqbal, Romaina
Diaz, Rafael
Yusoff, Khalid
Yusufali, Afzalhussein
Oguz, Aytekin
Wang, Xingyu
Penaherrera, Ernesto
Lanas, Fernando
Ogah, Okechukwu S.
Ogunniyi, Adesola
Iversen, Helle K.
Malaga, German
Rumboldt, Zvonko
Oveisgharan, Shahram
Hussain, Fawaz Al
Magazi, Daliwonga
Nilanont, Yongchai
Ferguson, John
Paré, Guillaume
Yusuf, Salim
INTERSTROKE investigators
dc.contributor.author.spa.fl_str_mv O’Donnell, Martin J.
Chin, Siu Lim
Rangarajan, Sumathy
Xavier, Denis
Liu, Lisheng
Zhang, Hongye
Rao Melacini, Purnima
Zhang, Xiaohe
Pais, Prem
Agapay, Steven
Lopez-Jaramillo, Patricio
Damasceno, Albertino
Langhorne, Peter
McQueen, Matthew J.
Rosengren, Annika
Dehghan, Mahshid
Hankey, Graeme J.
Dans, Antonio
ElSayed, Ahmed
Avezum, Alvaro
Mondo, Charles
Diener, Hans Christoph
Ryglewicz, Danuta
Czlonkowska, Anna
Pogosova, Nana
Weimar, Christian
Iqbal, Romaina
Diaz, Rafael
Yusoff, Khalid
Yusufali, Afzalhussein
Oguz, Aytekin
Wang, Xingyu
Penaherrera, Ernesto
Lanas, Fernando
Ogah, Okechukwu S.
Ogunniyi, Adesola
Iversen, Helle K.
Malaga, German
Rumboldt, Zvonko
Oveisgharan, Shahram
Hussain, Fawaz Al
Magazi, Daliwonga
Nilanont, Yongchai
Ferguson, John
Paré, Guillaume
Yusuf, Salim
INTERSTROKE investigators
dc.subject.proposal.eng.fl_str_mv Risk
Acute stroke
topic Risk
Acute stroke
description 15 p.
publishDate 2016
dc.date.issued.spa.fl_str_mv 2016-07-15
dc.date.accessioned.spa.fl_str_mv 2019-07-24T12:41:50Z
dc.date.available.spa.fl_str_mv 2019-07-24T12:41:50Z
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dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartof.eng.fl_str_mv The Lancet
dc.rights.spa.fl_str_mv Derechos Reservados - The Lancet, 2016
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dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.creativecommons.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)
dc.rights.uri.spa.fl_str_mv https://creativecommons.org/licenses/by-nc/4.0/
rights_invalid_str_mv Derechos Reservados - The Lancet, 2016
Atribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)
https://creativecommons.org/licenses/by-nc/4.0/
http://purl.org/coar/access_right/c_abf2
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institution Universidad de Santander
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We sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world, and in key populations and primary pathological subtypes of stroke. Methods We completed a standardised international case-control study in 32 countries in Asia, America, Europe, Australia, the Middle East, and Africa. Cases were patients with acute first stroke (within 5 days of symptom onset and 72 h of hospital admission). Controls were hospital-based or community-based individuals with no history of stroke, and were matched with cases, recruited in a 1:1 ratio, for age and sex. All participants completed a clinical assessment and were requested to provide blood and urine samples. Odds ratios (OR) and their population attributable risks (PARs) were calculated, with 99% confidence intervals. Findings Between Jan 11, 2007, and Aug 8, 2015, 26 919 participants were recruited from 32 countries (13 447 cases [10 388 with ischaemic stroke and 3059 intracerebral haemorrhage] and 13 472 controls). Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2·98, 99% CI 2·72–3·28; PAR 47·9%, 99% CI 45·1–50·6), regular physical activity (0·60, 0·52–0·70; 35·8%, 27·7–44·7), apolipoprotein (Apo)B/ApoA1 ratio (1·84, 1·65–2·06 for highest vs lowest tertile; 26·8%, 22·2–31·9 for top two tertiles vs lowest tertile), diet (0·60, 0·53–0·67 for highest vs lowest tertile of modified Alternative Healthy Eating Index [mAHEI]; 23·2%, 18·2–28·9 for lowest two tertiles vs highest tertile of mAHEI), waist-to-hip ratio (1·44, 1·27–1·64 for highest vs lowest tertile; 18·6%, 13·3–25·3 for top two tertiles vs lowest), psychosocial factors (2·20, 1·78–2·72; 17·4%, 13·1–22·6), current smoking (1·67, 1·49–1·87; 12·4%, 10·2–14·9), cardiac causes (3·17, 2·68–3·75; 9·1%, 8·0–10·2), alcohol consumption (2·09, 1·64–2·67 for high or heavy episodic intake vs never or former drinker; 5·8%, 3·4–9·7 for current alcohol drinker vs never or former drinker), and diabetes mellitus (1·16, 1·05–1·30; 3·9%, 1·9–7·6) were associated with all stroke. Collectively, these risk factors accounted for 90·7% of the PAR for all stroke worldwide (91·5% for ischaemic stroke, 87·1% for intracerebral haemorrhage), and were consistent across regions (ranging from 82·7% in Africa to 97·4% in southeast Asia), sex (90·6% in men and in women), and age groups (92·2% in patients aged ≤55 years, 90·0% in patients aged >55 years). We observed regional variations in the importance of individual risk factors, which were related to variations in the magnitude of ORs (rather than direction, which we observed for diet) and differences in prevalence of risk factors among regions. Hypertension was more associated with intracerebral haemorrhage than with ischaemic stroke, whereas current smoking, diabetes, apolipoproteins, and cardiac causes were more associated with ischaemic stroke (p<0·0001). Interpretation Ten potentially modifiable risk factors are collectively associated with about 90% of the PAR of stroke in each major region of the world, among ethnic groups, in men and women, and in all ages. However, we found important regional variations in the relative importance of most individual risk factors for stroke, which could contribute to worldwide variations in frequency and case-mix of stroke. Our findings support developing both global and region-specific programmes to prevent stroke. Funding Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Health Research Board Ireland, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland (Sweden), AstraZeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MSD, Chest, Heart and Stroke Scotland, and The Stroke Association, with support from The UK Stroke Research Network.application/pdf10.1016/S0140-6736(16)30506-20140-6736https://repositorio.udes.edu.co/handle/001/3452engThe LancetDerechos Reservados - The Lancet, 2016info:eu-repo/semantics/openAccessAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)https://creativecommons.org/licenses/by-nc/4.0/http://purl.org/coar/access_right/c_abf2https://www.researchgate.net/publication/305384265_Global_and_regional_effects_of_potentially_modifiable_risk_factors_associated_with_acute_stroke_in_32_countries_INTERSTROKE_A_case-control_study/link/59f0cf6ea6fdcc1dc7b8ef9e/downloadRiskAcute strokeGlobal and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE) : A case-control studyArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85PublicationTHUMBNAILGlobal and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE). 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