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Clinical factors in patients with ischemic versus hemorrhagic stroke in East China
Jing Zhang1, Yao Wang1, Gan-Nan Wang1
1Department of Emergency Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China (Zhang J, Wang Y, Wang GN, Sun H, Zhang JS); Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing 210029 China (Sun T); Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China (Shi JQ); Laboratory of Neurotoxicology, School of Public Health, Nanjing Medical University, Nanjing 210029, China (Xiao H).
Insights
Stroke risk factors differ between ischemic and hemorrhagic types, with hypertension being prominent overall. Understanding these distinct factors, including those specific to men and women, is key for targeted stroke prevention strategies.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Stroke remains a leading cause of death and disability globally, posing a significant public health challenge, particularly in China.
- Understanding the distinct etiological pathways of ischemic and hemorrhagic stroke is crucial for effective prevention and management.
- Investigating differential risk factors for stroke subtypes is essential to reduce incidence rates.
Purpose of the Study:
- To identify and analyze the distinct clinical factors associated with ischemic stroke versus hemorrhagic stroke.
- To explore sex-specific risk factors for stroke subtypes in the East China population.
- To inform targeted prevention strategies by elucidating differential risk factor impacts.
Main Methods:
- A cohort study involving 692 patients from East China, including 540 with ischemic stroke and 152 with hemorrhagic stroke.
- Collection and statistical analysis of clinical data to identify significant risk factors for each stroke subtype.
- Subgroup analysis to examine sex-specific risk factors for ischemic stroke.
Main Results:
- Factors associated with ischemic stroke included family history, obesity, carotid atherosclerosis, atrial fibrillation, hyperfibrinogenemia, TIA, coronary heart disease, low HDL, age, diabetes, and male gender.
- Hypertension, leukocytosis, and family history of hypertension were significantly linked to hemorrhagic stroke.
- Sex-specific findings revealed smoking, drinking, kidney disease, and low HDL-C in men; obesity, family history of hypertension/stroke, hypercholesteremia, and myocardial ischemia in women with ischemic stroke.
Conclusions:
- Hypertension, elevated pulse pressure, and hypercholesteremia were the primary risk factors for overall stroke in East China.
- Significant differences exist in the risk factors contributing to ischemic versus hemorrhagic stroke.
- Risk factor profiles for stroke exhibit notable variations between male and female patients, necessitating sex-specific approaches.
Background:
Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. Because the pathogenesis of ischemic stroke is different from that of hemorrhagic stroke, their clinical factors would not be the same. Therefore to investigate the different effects of various effect factors on ischemic versus hemorrhagic stroke and then to enhance the prevention are crucial to decrease the incidence.
Methods:
A total of 692 patients, consisting of 540 ischemic stroke patients and 152 hemorrhagic stroke patients from East China, were included in this study. The related factors of stroke subtypes were collected and analyzed.
Results:
The factors significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, obesity, atherosclerotic plaque of the common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack (TIA), atherosclerotic plaque of the internal carotid artery, coronary heart, lower high-density lipoproteins (lower HDL), increasing age, diabetes mellitus, and gender (male) (P<0.05). Leukocytosis, hypertension and family history of hypertension were the significant factors associated with hemorrhagic stroke versus ischemic stroke. Smoking, drinking, kidney diseases and lower HDL-C were the significant factors contributing to ischemic stroke in man. Obesity, family history of hypertension, family history of stroke, hypercholesteremia and myocardial ischemia were the significant factors for females with ischemic stroke.
Conclusions:
The most prominent factors for overall stroke in East China were hypertension, followed by higher pulse pressure and hypercholesteremia. The factors for ischemic and hemorrhagic stroke are not the same. Different effects of risk factors on stroke are found in male and female patients.
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