Stroke Risk Factors, Genetics, and Prevention.
Stroke Risk Factors, Genetics, and Prevention.
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DOI：
10.1161/circresaha.116.308398
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发表时间：
2017-02-03
影响因子：
20.1
通讯作者：
Elkind MS
中科院分区：
文献类型：
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作者：
Boehme AK;Esenwa C;Elkind MS
中风是一种异质性综合征，确定危险因素和治疗取决于中风的具体发病机制。中风的危险因素可以分为可改变的和不可改变的。年龄、性别和人种/种族是缺血性和出血性卒中的不可改变的风险因素，而高血压、吸烟、饮食和身体活动不足是一些更常见的可改变的风险因素。最近描述的中风的危险因素和触发因素包括炎性疾病、感染、污染和独立于心房颤动的心脏心房疾病。单基因疾病可能导致罕见的遗传性疾病，中风是主要表现。最近的研究还表明，常见和罕见的遗传多态性可以影响更常见的中风原因的风险，这是由于其他风险因素和特定的中风机制，如房颤。遗传因素，特别是那些与环境相互作用的因素，可能比以前认识到的更容易改变。中风预防通常集中在可改变的风险因素上。改变生活方式和行为，如改变饮食或戒烟，不仅可以降低中风风险，还可以降低其他心血管疾病的风险。其他预防策略包括识别和治疗会增加中风风险的疾病，如高血压和糖尿病。最近对中风的危险因素和遗传学的研究不仅确定了那些有中风风险的人，而且还确定了预防中风的目标人群的方法。
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention.