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[A case-control study of risk factors of acute cerebrovascular disease]
J Muñiz1, R Juane, A Castro-Beiras
1Grupo Gallego de Estudios Cardiovasculares, La Coruña.
Insights
This study identified key stroke risk factors in Galicia, including high blood pressure and alcohol consumption. These findings highlight modifiable targets for effective stroke prevention strategies.
Area of Science:
- Cardiovascular Disease Epidemiology
- Neurology
- Public Health
Context:
- Stroke is the leading cause of death in Galicia, with higher mortality in women compared to the rest of Spain.
- Understanding regional risk factors is crucial for targeted public health interventions.
Purpose:
- To investigate the specific risk factors associated with stroke incidence in the Galician population.
- To identify key factors for both primary and secondary stroke prevention.
Summary:
- A case-control study involving 76 stroke patients and 76 controls revealed significant associations between stroke and family history, prior stroke, atrial fibrillation, and hypertension.
- High alcohol consumption (≥80 g/day) and elevated serum cholesterol (≥250 mg/dl) were also linked to increased stroke risk.
- No significant association was found with cigarette smoking, and potential confounding factors in cholesterol measurement were noted.
Impact:
- Identifies hypertension and alcohol intake as critical, modifiable risk factors for primary stroke prevention.
- Reinforces the importance of primary prevention for individuals with a family history of stroke or atrial fibrillation.
- Emphasizes secondary prevention for those with a history of stroke or transient ischemic attack, given their high-risk status.
Background:
Stroke is the cardiovascular disease which causes the greatest number of deaths in Galicia, mortality, particularly in women, being higher than in the rest of Spain. The aim of this study was to investigate the risk factors of stroke and its importance in Galicia.
Methods:
A hospitalary study of cases and controls was performed including 76 patients with stroke and 76 controls individually paired for age, sex, population habitat and date of admission with anamnesis, weight, height and blood pressure, analysis and electrocardiogram being carried out in all.
Results:
An association was found between the disease and family history of stroke (odds ratio = 3.6, confidence interval 95% = 1.2-13.3), personal history of stroke (17.9; 4.0-79.1), personal history of atrial fibrillation (15.0; 3.3-68.3), high blood pressure (4.5; 1.9-11.6) and ingestion of alcohol greater than or equal to 80 g/day in comparison with abstemious patients adjusted for the effect of high blood pressure (2.5; 1.1-5.7). An association was also observed with serum cholesterol levels greater than or equal to 250 mg/dl (6.46 mmol/l) (3.3; 1.2-8.8, in comparison with cholesterol less than 200 mg/dl). No association was found with the cigarette smoking (1.2; 0.7-2.3).
Conclusions:
The results observed for high blood pressure and the ingestion of alcohol regardless of the same are of importance in primary prevention due to being modifiable risk factors. The association with family history of stroke and auricular fibrillation reinforce the needs for primary prevention measures in these subpopulations while having had a stroke or a transitory ischemic attack is the characteristic with the most risk reinforcing the need for secondary prevention measures which have found to be effective. The controls presented abnormally low cholesterol levels that do not reflect those of the population from which they originate, thus existing the possibility that the association observed is spurious.