Newer risk factors for stroke
Abstract
Stroke places a tremendous burden on health resources throughout the world. Improved detection and modification of risk factors could reduce the impact of this disease. Important non-modifiable risk factors for ischemic stroke include age, gender, ethnicity, and heredity. Modifiable risk factors include hypertension, cardiovascular disease, diabetes, hyperlipidemia, asymptomatic carotid stenosis, cigarette smoking, and alcohol abuse. Data from the Northern Manhattan Stroke Study provide new insights into these stroke risk factors.
In this study, African–Americans and Hispanics had a greater incidence of stroke, with almost a twofold increase compared with Caucasians. The protective effect of physical activity and moderate alcohol consumption was confirmed and further established as modifiable risk factors. The independent effects of lipids, apolipoproteins, and lipoprotein were also clarified. High-density lipoprotein was shown to be protective against ischemic stroke (particularly atherosclerotic stroke subtypes). Conversely, lipoprotein-a increased the risk for stroke. The ratio of apolipoprotein b to apolipoprotein a-1 was shown to be associated with carotid atheroma. In addition, newer risk factors, including homocysteine and chronic infection (Chlamydia pneumoniae and periodontal disease), are being studied as predictors of ischemic stroke. With these recent advances in the understanding of risk factors, the ability to detect or modify the risk for ischemic stroke should lead to a substantial reduction in the number of people killed or disabled by stroke each year.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Sacco RL, Boden-Albala B, Gan R, et al. Stroke incidence among white, black and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. Am J Epidemiol . 1998; 147: 259–268.
2.
Sacco RL, Boden-Albala B, Abel G, et al. Race-ethnic disparities in the impact of stroke risk factors: The Northern Manhattan Stroke Study. Stroke 2001 (in press).
3.
Sacco RL, Gan R, Boden-Albala B, et al. Leisure-time physical activity and ischemic stroke risk: the Northern Manhattan Stroke Study. Stroke . 1998; 29: 380–387.
4.
Sacco RL, Elkind M, Boden-Albala B, et al. The protective effect of moderate alcohol consumption on ischemic stroke. JAMA . 1999; 281: 53–60.
5.
Gorelick PB, Sacco RL, Smith D, et al. Prevention of a first stroke—A review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA . 1999; 281: 1112–1120.
6.
Sacco RL, Benson RT, Kargman DE, et al. High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. JAMA . 2001; 285: 2729–2735.
7.
Kargman DE, Berglund LF, Boden-Albala B, Lin IF, Paik MC, Sacco RL. Increased stroke risk and lipoprotein (a) in a racially mixed area: the Northern Manhattan Stroke Study. Stroke . 1999; 30: 251.
8.
Jeng JS, Sacco RL, Lui RC, Kargman DE, Boden-Albala B, Berglund L. Association of apolipoproteins to carotid artery atherosclerosis: the Northern Manhattan Stroke Study. Stroke . 1999; 30: 251.
9.
Sacco RL, Roberts JK, Jacobs BS. Homocysteine as a risk factor for ischemic stroke: an epidemiological story in evolution. Neuroepidemiology . 1998; 17: 167–173.
10.
Jacobs BS, Sacco RL, Roberts JK, Chen X, Paik MC, Stabler SP. Race-ethnicity and other environmental determinants of serum homocysteine in northern Manhattan. Stroke . 1998; 29: 277.
11.
Elkind MS, Lin IF, Grayston JT, Sacco RL. Chlamydia pneumoniae and the risk of first ischemic stroke. Stroke . 2000; 31: 1521–1525.
12.
Elkind MS, Desvarieux M, Boden-Albala B, et al. Periodontal disease is associated with internal carotid artery plaque thickness. Neurology . 1999; 52: A314.
Information & Authors
Information
Published In
Copyright
© 2001.
Publication History
Published online: September 1, 2001
Published in print: September 1, 2001
Authors
Metrics & Citations
Metrics
Citation information is sourced from Crossref Cited-by service.
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
Cited By
- Exploring Stroke Risk through Mendelian Randomization: A Comprehensive Study Integrating Genetics and Metabolic Traits in the Korean Population, Biomedicines, 12, 6, (1311), (2024).https://doi.org/10.3390/biomedicines12061311
- Risk factors for stroke among anthropometric indices and lipid profiles in the Korean population: a large-scale cross-sectional study, Scientific Reports, 13, 1, (2023).https://doi.org/10.1038/s41598-023-29902-4
- Motor sequela of adult and pediatric stroke: Imminent losses and ultimate gains, Motor System Disorders, Part II: Spinal Cord, Neurodegenerative, and Cerebral Disorders and Treatment, (305-346), (2023).https://doi.org/10.1016/B978-0-323-98817-9.00025-9
- Implementation of the Gamut of Physiotherapy Maneuvers in Restoration and Normalization of Functional Potencies in a Patient With a Hemorrhagic Stroke: A Case Report, Cureus, (2022).https://doi.org/10.7759/cureus.33035
- [Retracted] Effect of Blood Homocysteine on the Outcome of Artificial Insemination in Women with Polycystic Ovary Syndrome, BioMed Research International, 2022, 1, (2022).https://doi.org/10.1155/2022/6311419
- Involvements of Hyperhomocysteinemia in Neurological Disorders, Metabolites, 11, 1, (37), (2021).https://doi.org/10.3390/metabo11010037
- Plasma-based proteomics reveals lipid metabolic and immunoregulatory dysregulation in post-stroke depression, European Psychiatry, 29, 5, (307-315), (2020).https://doi.org/10.1016/j.eurpsy.2014.03.004
- Polymorphism of IL6 receptor gene is associated with ischaemic stroke in patients with metabolic syndrome, Brain Research, 1728, (146594), (2020).https://doi.org/10.1016/j.brainres.2019.146594
- Risk Factors, Transient Ischemic Attack and Stroke, (17-34), (2018).https://doi.org/10.1017/9781316161609.003
- Epidemiology, Transient Ischemic Attack and Stroke, (1-16), (2018).https://doi.org/10.1017/9781316161609.002
- See more
Loading...
View Options
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
The neurology.org payment platform is currently offline. Our technical team is working as quickly as possible to restore service.
If you need immediate support or to place an order, please call or email customer service:
- 1-800-638-3030 for U.S. customers - 8:30 - 7 pm ET (M-F)
- 1-301-223-2300 for customers outside the U.S. - 8:30 - 7 pm ET (M-F)
- [email protected]
We appreciate your patience during this time and apologize for any inconvenience.