Quantifying risk factor associations for the Primary Prevention of Stroke in different population subgroups

量化不同人群亚组中风一级预防的危险因素关联

• 批准号: 2072757
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2072757
• 关键词: Quantifying; risk; factor; associations; Primary

Stroke is a major global cause of morbidity and mortality. It is the fourth leading cause of death in the UK and a leading cause of adult disability, doubling the chances of dementia. With an ageing population, it is expected that by 2035, the absolute numbers of stroke events as well as the number of stroke survivors living with a disability in the UK will rise by a third. It is also well known that certain ethnic minorities bear a disproportionately larger burden of stroke. Thus, preventing stroke is of immense public health importance and expected to bring substantial savings for health and social care expenditures.Stroke as an outcome is strongly linked to cardiovascular health. Risk factors of stroke include the established biological, lifestyle and psychosocial determinants of, as well as wider socio-economic influences on, cardiovascular disease. Primary prevention of stroke by risk factor modification has been added as an extra domain in the latest European Stroke Action Plan - but further quantification of these risk relationships is recommended. Additionally, primordial prevention or preventing adverse levels of risk factors to begin with has been shown to be a powerful strategy for promoting and maintaining brain health. To this end, the American Heart Association has developed a collection of 7 metrics - Life's Simple 7 (LS7) to track cardiovascular health. These include smoking, BMI, physical activity, diet patterns, total cholesterol, blood pressure and fasting glucose; categorized into poor, intermediate and ideal levels based on selected cut-offs; for both adults and children. They are easily monitored, measurable and modifiable. The metrics are further combined to give an overall cardiovascular health score categorized as inadequate, average and optimal. However, data is lacking on their usefulness and suitability- individually and as a composite measure- in predicting a (fatal/nonfatal) stroke event in a multi ethnic British population. This would be especially useful since current EU scoring systems for e.g. SCORE, use cardiovascular disease mortality as an endpoint and are based on a limited number of modifiable risk factors (blood pressure, cholesterol and smoking). Others such as QRISK do not take intoaccount diet and physical activity. As such, a widely applicable (first time) stroke risk tool that takes into account multiple risk factors doesn't presently exist.

中风是全球发病和死亡的主要原因。它是英国第四大死因，也是成人残疾的主要原因，使患痴呆症的几率增加了一倍。随着人口老龄化，预计到 2035 年，英国中风事件的绝对数量以及残疾中风幸存者的数量将增加三分之一。众所周知，某些少数族裔承受着不成比例的更大的中风负担。因此，预防中风对于公共卫生具有巨大的重要性，预计将节省大量的健康和社会护理支出。中风作为一种结果与心血管健康密切相关。中风的危险因素包括心血管疾病的既定生物学、生活方式和心理社会决定因素，以及更广泛的社会经济影响。在最新的欧洲中风行动计划中，通过改变风险因素对中风进行一级预防已被添加为额外领域，但建议对这些风险关系进行进一步量化。此外，初步预防或从一开始就防止危险因素的不利水平已被证明是促进和维持大脑健康的有力策略。为此，美国心脏协会开发了一系列 7 个指标——Life's Simple 7 (LS7) 来跟踪心血管健康。这些包括吸烟、体重指数、体力活动、饮食模式、总胆固醇、血压和空腹血糖；根据选定的界限分为差、中等和理想水平；适合成人和儿童。它们易于监控、测量和修改。这些指标进一步结合起来，给出总体心血管健康评分，分为不充分、平均和最佳。然而，缺乏关于它们在预测多民族英国人口中（致命/非致命）中风事件方面的有用性和适用性（单独和作为综合措施）的数据。这将特别有用，因为当前的欧盟评分系统例如SCORE，使用心血管疾病死亡率作为终点，并基于有限数量的可改变的危险因素（血压、胆固醇和吸烟）。其他如 QRISK 则不考虑饮食和身体活动。因此，目前尚不存在考虑多种风险因素的广泛适用（首次）中风风险工具。

项目成果

Stroke risk in older British men: Comparing performance of stroke-specific and composite-CVD risk prediction tools.

• DOI: 10.1016/j.pmedr.2022.102098
• 发表时间: 2023-02
• 期刊: PREVENTIVE MEDICINE REPORTS
• 影响因子: 2.8
• 作者: Ahmed, Ayesha;Ambler, Gareth;Pereira, Snehal M. Pinto;Lennon, Lucy;Papacosta, Olia;Whincup, Peter;Wannamethee, Goya
• 通讯作者: Wannamethee, Goya