Long-term risk factors for stroke - Twenty-eight years of follow-up of 7457 middle-aged men in Goteborg, Sweden
Long-term risk factors for stroke - Twenty-eight years of follow-up of 7457 middle-aged men in Goteborg, Sweden
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DOI：
10.1161/01.str.0000226604.10877.fc
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发表时间：
2006-07-01
期刊：
影响因子：
8.3
通讯作者：
Wilhelmsen, Lars
中科院分区：
文献类型：
--
作者：
Harmsen, Per;Lappas, Georg;Wilhelmsen, Lars
背景和目的-评估在中年期随访28 years. Methods中测量的中风危险因素的预测价值-一个队列的7457名男性47至55岁，在基线1970年无中风进行了检查。中风的风险进行了分析，为整个期间和0至15，16至21，22至28年的后续使用年龄调整和多个考克斯回归analysis.Results-age，糖尿病，高血压与中风的风险增加，为整个28年和每个时期。既往短暂性脑缺血发作、房颤、胸痛史、吸烟和心理应激在整个随访期间以及前1或2个连续随访期间与卒中独立相关。中风或冠心病家族史没有独立的预后信息，血清胆固醇也没有。身体质量指数升高预测中风在后续的后期部分，所以做（几乎）低体力活动在休闲时间，连同抗高血压药物在baseline. Conclusions高血压和糖尿病保留其重要性，中风的危险因素，也超过了延长随访到老年。心血管疾病家族史与预后无显著相关性。短暂性脑缺血发作、房颤、应激、吸烟和胸痛史仅与第一个或前2个周期的结局相关。高体重指数和抗高血压药物在基线出现的风险因素在第二和第三十年。
Background and Purpose-To estimate the predictive value of risk factors for stroke measured in midlife over follow-up extending through 28 years.Methods-A cohort of 7457 men 47 to 55 years of age and free of stroke at baseline year 1970 were examined. Risk of stroke was analyzed for the entire period and for 0 to 15, 16 to 21, and 22 to 28 years of follow-up using age-adjusted and multiple Cox regression analyses.Results-Age, diabetes, and high blood pressure were independently associated with increased risk of stroke for the entire 28 years and for each of the periods. Previous transient ischemic attacks, atrial fibrillation, history of chest pain, smoking, and psychological stress were independently related to stroke for the entire follow-up period and also during the first 1 or 2 successive periods. Family history of stroke or of coronary disease carried no independent prognostic information, nor did serum cholesterol. Elevated body mass index predicted stroke during the later part of the follow-up and so did (almost) low physical activity during leisure time, together with antihypertensive medication at baseline.Conclusions-High blood pressure and diabetes retain their importance as stroke risk factors also over an extended follow-up into old age. A family history of cardiovascular disease was not significantly related to outcome. Transient ischemic attacks, atrial fibrillation, stress, smoking, and a history of chest pain were associated with outcome only for the first or the first 2 periods. High body mass index and antihypertensive medication at baseline emerged as risk factors in the second and third decades.