scholarly journals Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1952
Author(s):  
Anna Johansson ◽  
Isabel Drake ◽  
Gunnar Engström ◽  
Stefan Acosta

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Shahzad Alam Khan ◽  
Nasir Jamal Khan ◽  
Ikram Fareed Langrial ◽  
Saima Ashraf ◽  
Iqra Imtiaz

Objectives: To establish the association of raised LDL levels withvarious risk factors causing cerebral ischemia in stroke patients. Background: Cerebrovascular accident (CVA) is a health concern worldwide. Itcauses enormous disabilities in adult age group, and is 2ndcommonest cause of deaths throughout the world. It has been established thatapproximately 15 million people succumb to stroke each year worldwide, out of this 5 million don’t survive and another 5 million become permanently handicapped and thus put significant burden on catering families. This study was conducted to identify contribution of different risk factorsin causing ischemic stroke in our population. Study Design: Descriptive, purposive case series study. Setting: Medical Unit-IV, Nishtar Medical College/Hospital, Multan. Period: One Year tenure spread between January 2017 to December 2017. Material and Methods: 205 cases between 40-70 years of age includingboth male and female patients with ischemic stroke, irrespective of disease duration were included in study. History of raised BP, previous stroke, history of stroke in family, diabetes and smoking was recorded on pre-designed questionnaire. Body mass index was calculated after noting weight and height of the patient.Venous blood (5 ml) sample was drawn and sent to the pathology laboratory of Nishtar Hospital Multan for estimation of serum LDL level and blood glucose level. Results: Of these 205 study cases, 92 (44.9%) patients were male while 113 (55.1%) patients were female. Mean age of patients in our setting was noted to 51.58 ± 8.05 years. In our study, 50 (24.4%) patients were smokers and 40 (19.5%) had history of hypertension. In our setting, family history of stroke was present in 39 (19%) and previous history of stroke was found in 31 (15.1%). Mean body mass index of our patients was calculated to be 23.17± 2.85 kg/m2and 30(14.6%) cases were obese in our study. Mean fasting blood glucose level was 118.32 ± 23.21 mg/dl(48 (23.4%) had diabetes). Mean low density lipoprotein level (LDL) noted in our study was 109.59 ± 49.15 mg/dl and raised level of LDL was seen in 88 (42.9%) of our study cases. Conclusion: By identifying the share of various risk factors contributing in ischemic stroke, we can target population at risk of ischemic stroke and strict control and regulation of modifiable risk factors we can prevent this ominous condition to occur. Our study results point towards early diagnosis which will ultimately lead to proper management to improve clinical outcome in such patients. Raised levels of LDL were significantly associated with gender, diabetes, hypertension, obesity, family history and previous history of stroke.


1994 ◽  
Vol 72 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Goya Wannamethee ◽  
A Gerald Shaper

SummaryThe relationship between haematocrit and cardiovascular risk factors, particularly blood pressure and blood lipids, has been examined in detail in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns. The analyses are restricted to the 5494 men free of any evidence of ischaemic heart disease at screening.Smoking, body mass index, physical activity, alcohol intake and lung function (FEV1) were factors strongly associated with haematocrit levels independent of each other. Age showed a significant but small independent association with haematocrit. Non-manual workers had slightly higher haematocrit levels than manual workers; this difference increased considerably and became significant after adjustment for the other risk factors. Diabetics showed significantly lower levels of haematocrit than non-diabetics. In the univariate analysis, haematocrit was significantly associated with total serum protein (r = 0*18), cholesterol (r = 0.16), triglyceride (r = 0.15), diastolic blood pressure (r = 0.17) and heart rate (r = 0.14); all at p <0.0001. A weaker but significant association was seen with systolic blood pressure (r = 0.09, p <0.001). These relationships remained significant even after adjustment for age, smoking, body mass index, physical activity, alcohol intake, lung function, presence of diabetes, social class and for each of the other biological variables; the relationship with systolic blood pressure was considerably weakened. No association was seen with blood glucose and HDL-cholesterol. This study has shown significant associations between several lifestyle characteristics and the haematocrit and supports the findings of a significant relationship between the haematocrit and blood lipids and blood pressure. It emphasises the role of the haematocrit in assessing the risk of ischaemic heart disease and stroke in individuals, and the need to take haematocrit levels into account in determining the importance of other cardiovascular risk factors.


Author(s):  
Noraidatulakma Abdullah ◽  
Nor Abdul Murad ◽  
John Attia ◽  
Christopher Oldmeadow ◽  
Mohd Kamaruddin ◽  
...  

The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia.


2020 ◽  
Vol 3 (2) ◽  
pp. 337-343
Author(s):  
Helfrida Situmorang

The irreversible risk factors for osteoporosis are age, gender, race, family / hereditary history, body shape and history of fractures. The risk factors for osteoporosis that can be changed are smoking, vitamin and nutritional deficiencies, lifestyle, eating disorders (anorexia nervosa), early menopause, and the use of certain drugs such as corticosteroids, glucocorticosteroids, and diuretics. The purpose of this study was to determine the factors associated with the incidence of osteoporosis. The research design used was non-experimental, namely a correlational research design, namely research conducted to determine the relationship between two variables. The population in this study were all osteoporosis patients with age. over 45 years old who seek treatment at the Puskesmas Gunting Saga Kec. Kualuh Selatan District of North Labuhan Batu totaling 45 people. The sampling method used was the total sampling technique, which was the same as the population of 45 people. Data collection used is the method of filling out a questionnaire which includes written questions used to obtain data information from the questionnaire. The data analysis conducted was univariate analysis and bivariate analysis. In this study, researchers still adhere to ethical principles. The results illustrate that the respondents are mostly 51-65 years old as many as 27 people (60%). Most of the sex of respondents were women as many as 37 people (82.2 %%). Most of the respondents had no history of osteoporosis as many as 31 people (68.9%). Most of the body mass index of respondents whose body mass index was over 34 people (75.6%). Most of the respondents in the smoking category did not smoke as many as 32 people (71.7%). Most of the respondents' physical activity in the category of independent physical activity was 38 people (84.4%). The conclusion is that there is no relationship between age, sex, family history, body mass index, and smoking with the incidence of osteoporosis. Meanwhile, physical activity has a relationshipwithosteoporosis.   Abstrak Faktor-faktor resiko osteoporosis yang tidak dapat diubah yaitu usia, jenis kelamin, ras, riwayat keluarga/keturunan, bentuk tubuh dan sejarah patah tulang. Faktor–faktor resiko osteoporosis yang dapat diubah adalah merokok, defisiensi vitamin dan gizi, gaya hidup, gangguan makan (anoreksia nervosa), menopause dini, serta penggunaan obat-obatan tertentu seperti kortikosteroid, glukokortikosteroid, serta diuretik. Tujuan penelitian ini adalah untuk mengetahui mengetahui faktor-faktor yang berhubungan dengan kejadian osteoporosis Rancangan penelitian yang digunakan adalah non eksperimen yaitu rancangan atau desain penelitian yang bersifat korelasional yaitu penelitian yang dilakukan untuk mengetahui hubungan dua variabel.Populasi dalam penelitian ini adalah semua pasien osteoporosis dengan usia diatas 45 tahun yang berobat di Puskesmas Gunting Saga Kec. Kualuh Selatan Kab Labuhan Batu Utara berjumlah 45 orang.Metode pengambilan sampel yang digunakan dengan teknik total sampling yaitu sama dengan populasi adalah sebanyak 45 orang. Pengumpulan data yang digunakan yaitu metode pengisian kuesioner yang meliputi pertanyaan tertulis yang digunakan untuk memperoleh informasidata dari kuesioner.Analisa data yang dilakukan adalah analisis univariat dan analisis bivariat. Dalam penelitian ini peneliti tetap berpedoman pada prinsip-prinsip etik.Hasil penelitian menggambarkan bahwa responden sebagian besar berumur 51-65 tahun sebanyak 27 orang (60%). Jenis kelamin responden sebagian besar wanita sebanyak  37 orang (82.2%%).Riwayat keluarga responden sebagian besar berstatus tidak ada riwayat osteoporosis sebanyak 31 orang (68.9%).Indeks masa tubuh responden sebagian besar Indeks masa tubuh lebih sebanyak 34 orang (75.6%).Merokok responden sebagian besar kategori tidak merokok sebanyak 32 orang (71.7%).Aktivitas fisik responden sebagian besar kategori aktivitas fisik mandiri sebanyak 38 orang (84.4%).Kesimpulan bahwa tidak ada hubungan umur, jeniskelamin, riwayat keluarga,indeks massa tubuh,dan merokok dengan kejadian osteoporosis. Sedangkan aktivitas fisikada hubungan dengan kejadian osteoporosis.


Author(s):  
Shyam Sundar Ganguly ◽  
Arunodaya R. Gujjar ◽  
Hasina Al Harthi ◽  
Amal Al Hashmi ◽  
Sanjay Jaju ◽  
...  

Objectives: Stroke is recognized to be the third most common cause of mortality, with increasing incidence among developing countries. Recognition and control of risk factors is of prime importance in the prevention of stroke. We aimed to study the characteristics of ischemic stroke (IS) patients in Oman, and quantify its various risk factors using a case-control model. Methods: This study conducted from January 2012 to March 2013 included 255 adult Omani patients with IS admitted to two premier hospitals in Oman, compared to 255 age- and gender-matched controls. Demographic factors and frequency of various conventional risk factors were documented. Univariate and step-wise multivariate logistic regression analysis were performed to evaluate the risk factors associated for IS. Results: Of the 255 cases, 63% were males. The mean age was 62.2 ± 13.2 years. Most of the cases (89%)  were above 45 years of age. Cardio-embolism(32%) was the commonest mechanism of IS. The stepwise multiple logistic regression model revealed that family history of stroke was the strongest independent risk factor with odds ratio (OR) of 10.10, followed by hypertension with OR of 5.17 and high-density lipoprotein with OR 3.34 (p< 0.01). Conclusions: Cardio-embolism was the predominant mechanism of IS in this study. Family history of stroke, hypertension and reduced high-density lipoprotein were the leading independent risk factors. Strong emphasis on screening for risk factors, control of hypertension and life-style modification for those with family history of stroke, would be expected to emerge as the major stroke-preventive measures in Oman. Keywords:  Ischemic stroke; Risk factors; Case-control study; Oman.


2010 ◽  
Vol 8 (1) ◽  
pp. 88-97 ◽  
Author(s):  
Alexander Omolafe ◽  
Michele Mouttapa ◽  
Shari McMahan ◽  
Sora Park Tanjasiri

This cross-sectional study sought to describe an association between family history of type-2 diabetes and the awareness of risk factors, perceived threat and physical activity levels in African Americans. With a prevalence of 11.8%, African Americans remain disproportionately affected by the epidemic of diabetes. A risk factor that cannot be modified, but is important and closely linked with diabetes expression, family history, can be a considerable tool in promoting behavior change and reducing the risk of developing the condition in African Americans. A self-report questionnaire was administered to 133 church going African Americans, with 55 of them with a positive family history of type-2 diabetes (41.4%) and 78 (58.6%) without. None of the participants had been previously been diagnosed with type-2 diabetes. The results from the study indicated that African Americans with positive family history had a greater knowledge of risk factors, were more likely to indicate that their concern about the disease influences their eating habits and physical activity, and engaged in significantly more physical activity than those with no family history.


2019 ◽  
Vol 1 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Bikash Shrestha ◽  
Bipin Nepal ◽  
Yagya Laxmi Shakya ◽  
Binaya Regmi

 Introduction: Type 2 diabetes mellitus is the commonest form of diabetes affecting more than 90% of the diabetic population worldwide. The prevalence of type 2 diabetes and its complications are increasing in the world, including developing nations like Nepal. This study aimed to determine the association between the lifestyle risk factors and the risk of type 2 diabetes mellitus in Nepalese population. Methods: This is hospital based cross sectional observational study done in the urban area of Nepal. Records of clients coming for the general health checkup in Grande International Hospital were evaluated in this study. Comparisons of the lifestyle factors in participants having and not having type 2 diabetes mellitus were done. Results: Significant associations with diagnosis of diabetes mellitus (DM) type 2 were seen in age (P ≤ 0.001), associated hypertension (P ≤ 0.001), dyslipidemia, family history of DM (P ≤ 0.001), alcohol use (P ≤ 0.001), and tobacco use (P ≤ 0.001). Logistic regression analysis showed that the odds of having diabetes were high in age group above 40 (OR – 6.9, CI 3.82 – 12.47), history of hypertension (OR- 3.84, CI 2.42 – 6.08), tobacco users (OR-2.26, CI 1.12 – 4.53), alcohol users (OR-3.99, CI 2.47 – 6.44), family history of DM (OR-2.44, CI 1.53 – 3.89), and abdominal obesity in both males (OR-3.9, CI 2 – 7.4) and females (OR-9.6, CI 3.78 – 24.35). Conclusions: The modifiable risk factors - obesity, smoking and alcohol use carry significant risks of developing type 2 diabetes. These red flag signs call for urgent attention to look for and rectify the modifiable risk factors in Nepalese population to prevent diabetes.


2020 ◽  
Author(s):  
Haibin Dong ◽  
Yutang Ren ◽  
Bo Jiang

Abstract Objectives Interval colorectal advanced adenoma (I-CRAA) carries insidious risk of interval colorectal cancer (I-CRC). The study aims to determine the frequency of I-CRAA after negative colonoscopy and discover the characteristics and the risk factors.Methods We retrospectively analyzed the information of the patients undergoing colonoscopy in the endoscopic center (2015-2019). Frequency of I-CRAA was calculated. The clinical features of I-CRAA were compared with sporadic colorectal advanced adenoma (Sp-CRAA). Results The frequency of I-CRAA was 0.71% (112/15759) per colonoscopy. I-CRAA was more likely to be located in the proximal colon (65.2% vs 34.8%, p<0.05) and has high pathological grade (5.4% vs 1.6%, p<0.05). Diabetes, family history of CRC, smoking, alcohol intake and diverticulosis are risk factors for I-CRAA(p<0.05). Excellent bowel preparation (OR 3.727; 95% CI 2.425–5.73, p<0.001) and higher adenoma detection rate (OR 1.924; 95% CI 1.153–3.21, p = 0.012) are helpful for the detection of I-CRAA. I-CRAA found within 1 year other than 2 or 3 years after the initial colonoscopy were usually found by an endoscopist with higher ADR.Conclusions I-CRAA is usually located in the proximal colon and has high pathological grade. Diabetes, diverticulosis, smoking history, alcohol intake, and family history of CRC are the risk factors. Its occurrence is more related to low-quality colonoscopy, especially within one year.


2021 ◽  
Vol 15 (10) ◽  
pp. 3417-3419
Author(s):  
Murtaza Jaffar ◽  
Adil Rafique ◽  
Sidra Khalid ◽  
Shahid Waheed

Background and Aim: A stroke, also known as a cerebrovascular accident, is defined as the sudden onset of a focal neurologic deficit caused by a disruption in blood flow to parts of the brain. The purpose of this study was to evaluate the frequency of dyslipidemia in stroke patients. Materials and Methods: This cross-sectional study was carried out on 184 stroke patients in Medical department of Services Hospital, Lahore for duration of six months i.e from November 2020 to June 2021. All the stroke patients admitted during the study period were enrolled. Demographic details, past medical and family history, stroke risk factors, blood pressure, body mass index, and diabetic state were noted. Fasting blood samples were taken from individuals of stroke diagnosed based on CT scan. Lipid profiles including triacylglycerol, cholesterol, fasting blood glucose, low-density lipoproteins, and glycosylated hemoglobin were all measured from an individual blood samples. SPSS version 20 was used for data analysis. Results: Of the total 184 stroke patients, 123 (66.8%) were male patients while 61 (33.2%) were females. The overall mean age was 41.35±12.76 years whereas the mean body mass index was 37.61±10.91 Kg/m2. Out of 184 patients, the prevalence of prevalent risk factors such as hypertension, diabetes mellitus, and smoking was found 146 (79.5%), 89 (48.2%), and 58 (31.7%) respectively. The prevalence of Hypercholesterolemia (mg/dl), Hypertriglyceridemia (mg/dl), High LDL (mg/dl) levels, high VLDL (mg/dl), and low HDL was 49 (26.4%), 37 (20.1%), 31 (16.8%), 23 (12.5%), and 13 (7.1%) respectively. The abnormalities in HbA1c and fasting blood glucose were found in 93 (50.6%) and 95 (51.4%). Conclusion: Dyslipidemia was more prevalent in ischemic stroke patients. The smoker and male population are more susceptible to stroke risks that involve high LDL, high HbA1c, low HDL, hypertension, and higher fast blood glucose. Family history and diabetes are other risk factors for stroke. Appropriate intrusion for alteration of uneven lipid profile can improve stroke prognosis and prevention Keywords: Dyslipidemia; Ischemic Stroke, Cholesterol


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