TY - JOUR
T1 - Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study
AU - O'Donnell, M.J.
AU - Chin, S.L.
AU - Rangarajan, S.
AU - Xavier, D.
AU - Liu, L.
AU - Zhang, H.
AU - Rao-Melacini, P.
AU - Zhang, X.
AU - Pais, P.
AU - Agapay, S.
AU - Lopez-Jaramillo, P.
AU - Damasceno, A.
AU - Langhorne, P.
AU - Mcqueen, M.J.
AU - Rosengren, A.
AU - Dehghan, M.
AU - Hankey, Graeme J.
AU - Dans, A.L.
AU - Elsayed, A.
AU - Avezum, A.
AU - Mondo, C.
AU - Diener, H.C.
AU - Ryglewicz, D.
AU - Czlonkowska, A.
AU - Pogosova, N.
AU - Weimar, C.
AU - Iqbal, R.
AU - Diaz, R.
AU - Yusoff, K.
AU - Yusufali, A.
AU - Oguz, A.
AU - Wang, X.
AU - Penaherrera, E.
AU - Lanas, F.
AU - Ogah, O.S.
AU - Ogunniyi, A.
AU - Iversen, H.K.
AU - Malaga, G.
AU - Rumboldt, Z.
AU - Oveisgharan, S.
AU - Al Hussain, F.
AU - Magazi, D.
AU - Nilanont, Y.
AU - Ferguson, J.
AU - Pare, G.
AU - Yusuf, S.
PY - 2016/8/20
Y1 - 2016/8/20
N2 - © 2016 Elsevier Ltd Background Stroke is a leading cause of death and disability, especially in low-income and middle-income countries. We sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world, and in key populations and primary pathological subtypes of stroke. Methods We completed a standardised international case-control study in 32 countries in Asia, America, Europe, Australia, the Middle East, and Africa. Cases were patients with acute first stroke (within 5 days of symptom onset and 72 h of hospital admission). Controls were hospital-based or community-based individuals with no history of stroke, and were matched with cases, recruited in a 1:1 ratio, for age and sex. All participants completed a clinical assessment and were requested to provide blood and urine samples. Odds ratios (OR) and their population attributable risks (PARs) were calculated, with 99% confidence intervals. Findings Between Jan 11, 2007, and Aug 8, 2015, 26?919 participants were recruited from 32 countries (13?447 cases [10?388 with ischaemic stroke and 3059 intracerebral haemorrhage] and 13?472 controls). Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2·98, 99% CI 2·72–3·28; PAR 47·9%, 99% CI 45·1–50·6), regular physical activity (0·60, 0·52–0·70; 35·8%, 27·7–44·7), apolipoprotein (Apo)B/ApoA1 ratio (1·84, 1·65–2·06 for highest vs lowest tertile; 26·8%, 22·2–31·9 for top two tertiles vs lowest tertile), diet (0·60, 0·53–0·67 for highest vs lowest tertile of modified Alternative Healthy Eating Index [mAHEI]; 23·2%, 18·2–28·9 for lowest two tertiles vs highest tertile of mAHEI), waist-to-hip ratio (1·44, 1·27–1·64 for highest vs lowest tertile; 18·6%, 13·3–25·3 for top two tertiles vs lowest), psychosocial factors (2·20, 1·78–2·72; 17·4%, 13·1–22·6), current smoking (1·67, 1·49–1·87; 12·4%, 10·2–14·9), cardiac causes (3·17, 2·68–3·75; 9·1%, 8·0–10·2), alcohol consumption (2·09, 1·64–2·67 for high or heavy episodic intake vs never or former dr
AB - © 2016 Elsevier Ltd Background Stroke is a leading cause of death and disability, especially in low-income and middle-income countries. We sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world, and in key populations and primary pathological subtypes of stroke. Methods We completed a standardised international case-control study in 32 countries in Asia, America, Europe, Australia, the Middle East, and Africa. Cases were patients with acute first stroke (within 5 days of symptom onset and 72 h of hospital admission). Controls were hospital-based or community-based individuals with no history of stroke, and were matched with cases, recruited in a 1:1 ratio, for age and sex. All participants completed a clinical assessment and were requested to provide blood and urine samples. Odds ratios (OR) and their population attributable risks (PARs) were calculated, with 99% confidence intervals. Findings Between Jan 11, 2007, and Aug 8, 2015, 26?919 participants were recruited from 32 countries (13?447 cases [10?388 with ischaemic stroke and 3059 intracerebral haemorrhage] and 13?472 controls). Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2·98, 99% CI 2·72–3·28; PAR 47·9%, 99% CI 45·1–50·6), regular physical activity (0·60, 0·52–0·70; 35·8%, 27·7–44·7), apolipoprotein (Apo)B/ApoA1 ratio (1·84, 1·65–2·06 for highest vs lowest tertile; 26·8%, 22·2–31·9 for top two tertiles vs lowest tertile), diet (0·60, 0·53–0·67 for highest vs lowest tertile of modified Alternative Healthy Eating Index [mAHEI]; 23·2%, 18·2–28·9 for lowest two tertiles vs highest tertile of mAHEI), waist-to-hip ratio (1·44, 1·27–1·64 for highest vs lowest tertile; 18·6%, 13·3–25·3 for top two tertiles vs lowest), psychosocial factors (2·20, 1·78–2·72; 17·4%, 13·1–22·6), current smoking (1·67, 1·49–1·87; 12·4%, 10·2–14·9), cardiac causes (3·17, 2·68–3·75; 9·1%, 8·0–10·2), alcohol consumption (2·09, 1·64–2·67 for high or heavy episodic intake vs never or former dr
U2 - 10.1016/S0140-6736(16)30506-2
DO - 10.1016/S0140-6736(16)30506-2
M3 - Article
SN - 0140-6736
VL - 388
SP - 761
EP - 775
JO - The Lancet
JF - The Lancet
IS - 10046
ER -