Risk factors for ischemic stroke; results from 9 years of follow-up in a population based cohort of Iran.
Risk factors for ischemic stroke; results from 9 years of follow-up in a population based cohort of Iran.
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DOI：
10.1186/1471-2377-12-117
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发表时间：
2012-10-02
期刊：
影响因子：
2.6
通讯作者：
Hadaegh F
中科院分区：
文献类型：
--
作者：
Fahimfar N;Khalili D;Mohebi R;Azizi F;Hadaegh F
在中东人群中，关于中风危险因素的数据很少。我们的目的是确定潜在的危险因素和他们的人口归因分数（PAF）的中风在伊朗的人口。一项队列研究包括1089名男性和1289名女性，平均（SD）年龄分别为61.1（7.6）岁和59.0（6.7）岁。采用考克斯回归分析，以逐步方法估计各卒中事件危险因素的风险比（HR）。我们计算了多变量调整的人群归因分数（PAF）的任何风险因素仍然在模型中。在9.3年的随访期间，发生了69起卒中事件，男性和女性的发病率分别为4.5（95% CI：3.3-6.0）和2.5（1.7-3.6）/1000人-年。在潜在风险因素中，仅年龄≥ 65岁（HR：2.03，CI：1.24-3.31），男性（HR：2.00，CI：1.16-3.43），高血压（HR：3.03，CI：1.76-5.22），糖尿病（HR：2.18，CI：1.34-3.56）和慢性肾病（CKD）（HR：2.01，CI：1.22-3.33）与总人群中卒中事件风险增加独立相关。配对同质性检验显示，CKD的风险比与其他独立危险因素没有差异。男性和年龄≥ 65岁的PAF不可改变的危险因素分别为29.7%和25%，高血压、CKD和糖尿病的PAF可改变的危险因素分别为48.6%、29.1%和22.0%。在对伊朗人进行这项基于人群的研究后，我们证明了在可改变的风险因素中，CKD以及高血压和糖尿病是中风最强的独立预测因素。
Data about the risk factors of stroke are sparse in the Middle East populations. We aimed to determine the potential risk factors and their population attributable fraction (PAF) for stroke in an Iranian population. A cohort Study consisted of 1089 men and 1289 women, with mean (SD) ages of 61.1(7.6) and 59.0(6.7) years, respectively. Cox regression was implemented to estimate the hazard ratio (HR) of each risk factor for stroke events in a stepwise method. We calculated a multivariate adjusted population attributable fraction (PAF) for any risk factors remained in the model. During 9.3 years of follow-up, 69 events of stroke occurred with incidence rates of 4.5 (95% CI: 3.3-6.0) and 2.5 (1.7-3.6) in 1000 person-years for men and women respectively. Among potential risk factors, only age ≥ 65 years (HR: 2.03, CI: 1.24-3.31), male gender (HR: 2.00, CI: 1.16-3.43), hypertension (HR: 3.03, CI: 1.76-5.22), diabetes mellitus (HR: 2.18, CI: 1.34-3.56), and chronic kidney disease (CKD) (HR: 2.01, CI: 1.22-3.33), were independently associated with increased risk of stroke events in the total population. A paired homogeneity test showed that the hazard ratio of CKD did not differ from other independent risk factors. The PAFs were 29.7% and 25% for male gender and age ≥ 65 as non-modifiable and 48.6%, 29.1% and 22.0% for hypertension, CKD and diabetes as modifiable risk factors respectively. Following this population based study of Iranians, we demonstrated that among modifiable risk factors, CKD as well as hypertension and diabetes are the strongest independent predictors of stroke.