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Multiple modifiable risk factors for first ischemic stroke: a population-based epidemiological study.

D I Hadjiev1, P P Mineva, M I Vukov

  • 1Medical University, Sofia, Bulgaria. dimiter_hadjiev@hotmail.com

European Journal of Neurology
|August 28, 2003
PubMed
Summary

Over half of Bulgarian urban adults studied had multiple vascular risk factors. Combinations like hypertension with cardiac disease significantly increased stroke and heart attack risks.

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Area of Science:

  • Epidemiology
  • Vascular Health
  • Public Health

Background:

  • Multiple modifiable vascular risk factors are prevalent in urban populations.
  • Understanding their distribution and outcomes is crucial for public health.
  • Previous studies have not fully characterized these factors in Bulgarian adults.

Purpose of the Study:

  • To determine the prevalence, distribution, and outcomes of multiple modifiable vascular risk factors in a Bulgarian urban population.
  • To identify specific risk factor combinations associated with adverse vascular events.
  • To inform primary prevention strategies for stroke and cardiovascular disease.

Main Methods:

  • Population-based cohort study involving 500 volunteers aged 50-79.
  • Data collection included questionnaires, physical examinations, laboratory tests, and carotid duplex scanning.

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  • Follow-up over 2 years to record transient ischemic attacks (TIAs), ischemic stroke, and myocardial infarction.

    • Main Results:

    • 52% of subjects had three or more modifiable vascular risk factors.
    • Hypertension, dyslipidemias, obesity, smoking, and cardiac diseases were most common.
    • Asymptomatic carotid stenosis (ACS) was found in 8.8% of those with risk factors.
    • Combinations of hypertension and cardiac disease, cardiac disease and obesity, and ACS with high LDL cholesterol were significantly associated with adverse outcomes.

    Conclusions:

    • Multiple vascular risk factors are highly prevalent in this Bulgarian urban cohort.
    • Specific combinations of risk factors significantly increase the risk of major vascular events.
    • Identifying individuals with multiple risk factors is vital for targeted primary prevention of stroke and cardiovascular disease.