Ethnic differences in risk factors for ischemic stroke - A European case-control study
Ethnic differences in risk factors for ischemic stroke - A European case-control study
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DOI：
10.1161/01.str.0000131903.04708.b8
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发表时间：
2004-07-01
期刊：
影响因子：
8.3
通讯作者：
Wolfe, CDA
中科院分区：
文献类型：
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作者：
Hajat, C;Tilling, K;Wolfe, CDA
背景和目的-目的是估计缺血性卒中危险因素的相对危险度和人群归因危险度（PAR）的ethnicitygroup.Methods -在本病例对照研究中，首次缺血性卒中的病例取自南伦敦卒中登记处，对照组取自同一地区的横断面患病率调查。根据种族组确定每个风险因素的PAR。多变量分析被用来检查所有种族之间的危险因素和缺血性中风的关联。结果- 664例和716对照组，年龄在45至74岁，种族的白色78%：42%，加勒比黑人16%：43%，非洲黑人6%：15%，分别。对于白色组，在ECG上发现缺血性心脏病（IHD）的高PAR（56% [ 95% CI，49%至62%]），肥胖（49% [ 95% CI，40%-56%]），高血压（HT）（38% [ 95% CI，29%-46%]），吸烟（31% [ 95% CI，19%至41%]）、短暂性脑缺血发作（TIA）（23% [ 95% CI，19%至27%]）和房颤（AF）（16% [ 95% CI，10%至21%]）。在加勒比黑人组中，HT的PAR高于白色组（46% [ 95% CI，21%-63%]）和糖尿病（DM）（29% [ 95% CI，14%至42%]），当前吸烟（18% [ 95% CI，1%至32%]）和AF（10% [ 95% CI，0%至18%]）的患者更低。在非洲黑人组中，HT的PAR（59% [ 95% CI，91%-82%]）高于其他组。AF（11% [ 95% CI，- 11%至29%]）、肥胖（30% [ 95% CI，- 20%至60%]）和DM（4% [ 95% CI，- 25%至26%]）的PAR低于其他组。在多变量分析中，与缺血性卒中相关的危险因素包括TIA，AF，IHD的心电图，吸烟，过量饮酒，肥胖，HT，和DM。结论-在第一个欧洲病例对照研究中，在加勒比黑人和非洲人群缺血性卒中的危险因素，这些群体之间的危险因素的影响表现出一些差异。在制定中风预防策略时，解决这些差异可能很重要。
Background and Purpose - The aim is to estimate the relative risk and population attributable risk ( PAR) of risk factors for ischemic stroke by ethnic group.Methods - In this case - control study, cases of first ischemic stroke were taken from the South London Stroke Register and controls from a cross-sectional prevalence survey covering the same area. PAR was determined for each risk factor by ethnic group. Multivariable analysis was used to examine the association between risk factors and ischemic stroke across all ethnic groups.Results - 664 cases and 716 controls aged 45 to 74 years were included, with ethnicity of white 78%: 42%, black Caribbean 16%: 43%, and black African 6%: 15%, respectively. For the white group, high PAR was found for ischemic heart disease (IHD) on ECG (56% [ 95% CI, 49% to 62%]), obesity ( 49% [ 95% CI, 40% to 56%]), hypertension ( HT) (38% [ 95% CI, 29% to 46%]), smoking (31% [ 95% CI, 19% to 41%]), transient ischemic attack (TIA) (23% [ 95% CI, 19% to 27%]), and atrial fibrillation (AF) ( 16% [ 95% CI, 10% to 21%]). In the black Caribbean compared with the white group, PAR was higher for HT ( 46% [ 95% CI, 21% to 63%]) and diabetes mellitus (DM) ( 29% [ 95% CI, 14% to 42%]), and lower for current smoking ( 18% [ 95% CI, 1% to 32%]) and AF ( 10% [ 95% CI, 0% to 18%]). In the black African group HT had a higher PAR (59% [ 95% CI, 91% to 82%]) than the other groups. PAR for AF (11% [ 95% CI, - 11% to 29%]), obesity (30% [ 95% CI, - 20% to 60%]), and DM (4% [ 95% CI, - 25% to 26%]) was low compared with the other groups. In multivariable analysis, risk factors associated with ischemic stroke included TIA, AF, IHD on ECG, smoking, excess alcohol, obesity, HT, and DM.Conclusion - In the first European case-control study examining risk factors for ischemic stroke in black Caribbean and African populations, some differences were demonstrated in the impact of risk factors between these groups. It may be important to address such differences when developing stroke preventative strategies.