Age-Specific Vascular Risk Factor Profiles According to Stroke Subtype.
Age-Specific Vascular Risk Factor Profiles According to Stroke Subtype.
复制标题
DOI：
10.1161/jaha.116.005090
复制
发表时间：
2017-05-08
影响因子：
5.4
通讯作者：
Dutch Parelsnoer Institute‐Cerebrovascular Accident Study Group
中科院分区：
文献类型：
--
作者：
Hauer AJ;Ruigrok YM;Algra A;van Dijk EJ;Koudstaal PJ;Luijckx GJ;Nederkoorn PJ;van Oostenbrugge RJ;Visser MC;Wermer MJ;Kappelle LJ;Klijn CJM;Dutch Parelsnoer Institute‐Cerebrovascular Accident Study Group
缺血性和出血性卒中越来越被认为是具有不同亚型和病因的异质性疾病。关于卒中亚型中血管危险因素分布随年龄变化的信息有限。我们调查了与年龄相关的卒中亚型中血管危险因素的患病率。我们研究了一个前瞻性多中心大学医院队列，其中包括4033名患者。对于由大动脉粥样硬化、小血管疾病或心源性栓塞引起的缺血性卒中患者，以及自发性脑出血或蛛网膜下腔出血患者，我们计算了4个年龄组（<55岁、55 - 65岁、65 - 75岁和≥75岁）的血管危险因素患病率，以及与参考年龄组的平均差异和95%CI。年龄<55岁的患者中，非白色血统的患者明显更多（特别是自发性脑内出血和动脉瘤性蛛网膜下腔出血患者），并且最常吸烟（对于动脉瘤性蛛网膜下腔出血患者来说最突出）。年龄<55岁的大动脉粥样硬化或小血管疾病引起的缺血性卒中患者比心源性缺血性卒中患者更常患有高血压、高脂血症和糖尿病。总的来说，在所有中风亚型中，高血压、高脂血症和糖尿病的发生率随年龄的增长而增加，而吸烟则随年龄的增长而减少。无论年龄大小，大动脉粥样硬化或小血管疾病引起的缺血性卒中患者中潜在可改变的危险因素的积累最为明显。常见心血管危险因素的患病率在各种卒中亚型中显示出不同的年龄特异性模式。认识到这些模式可能会指导针对特定风险群体的有针对性的卒中预防工作。
Ischemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age. We studied a prospective multicenter university hospital–based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage, we calculated prevalences of vascular risk factors in 4 age groups: <55, 55 to 65, 65 to 75, and ≥75 years, and mean differences with 95% CIs in relation to the reference age group. Patients aged <55 years were significantly more often of non‐white origin (in particular in spontaneous intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage patients) and most often smoked (most prominent for aneurysmal subarachnoid hemorrhage patients). Patients aged <55 years with ischemic stroke caused by large artery atherosclerosis or small vessel disease more often had hypertension, hyperlipidemia, and diabetes mellitus than patients with ischemic stroke of cardiac origin. Overall, the frequency of hypertension, hyperlipidemia, and diabetes mellitus increased with age among all stroke subtypes, whereas smoking decreased with age. Regardless of age, accumulation of potentially modifiable risk factors was most pronounced in patients with ischemic stroke caused by large artery atherosclerosis or small vessel disease. The prevalence of common cardiovascular risk factors shows different age‐specific patterns among various stroke subtypes. Recognition of these patterns may guide tailored stroke prevention efforts aimed at specific risk groups.