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Related Experiment Video

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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
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Prevention paradox between stroke and multiple potential risk factors using data from a population-based cohort

Takao Kojo1, Ryusuke Ae2, Koki Kosami2

  • 1Department of Health Management, Undergraduate School of Health Studies, Tokai University, Kanagawa, Japan.

Preventive Medicine
|October 23, 2021
PubMed
Summary

The prevention paradox may not apply to stroke prevention when considering multiple risk factors. Focusing on individuals with 1-3 risk factors, like hypertension, may be more effective than targeting single factors.

Keywords:
High-risk strategyPopulation strategyPrevention paradoxStroke

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Area of Science:

  • Epidemiology
  • Cardiovascular Disease Prevention

Background:

  • The prevention paradox suggests population-based strategies are superior to high-risk ones for single risk factors.
  • Its applicability to multiple simultaneous risk factors for stroke remains unclear.

Purpose of the Study:

  • To test if the prevention paradox applies when multiple stroke risk factors are considered simultaneously.
  • To compare the effectiveness of high-risk versus population-based strategies for stroke prevention.

Main Methods:

  • A cohort of 9051 Japanese individuals (aged 40-89) was analyzed.
  • Time-dependent Cox proportional-hazards models identified stroke risk factors.
  • Participants were classified by single risk factor versus 1-3 risk factors (hypertension, hyperglycemia, dyslipidemia).

Main Results:

  • Hypertension was a primary stroke risk factor across all demographics.
  • Stroke incidence was 46%-63% for single risk factors versus 71%-83% for 1-3 risk factors.
  • The prevention paradox was not observed when multiple risk factors were present.

Conclusions:

  • A high-risk strategy targeting individuals with multiple stroke risk factors appears more effective.
  • This approach may offer better stroke prevention than focusing on single risk factors alone.