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{{Ischemic stroke}}
{{Ischemic stroke}}
{{CMG}}
{{CMG}}{{AE}}{{AA}}
==Overview==
==Overview==
Risk factors for stroke include [[Old age|advanced age]], [[hypertension]] (high blood pressure), previous stroke or TIA ([[transient ischaemic attack]]), [[diabetes mellitus]], [[hypercholesterolemia|high cholesterol]], [[cigarette smoking]], [[atrial fibrillation]], [[migraine]]<ref>[http://headaches.about.com/od/migrainediseas1/a/mx_stroke_risk.htm headaches.about.com]</ref> with aura, and [[thrombophilia]]. In clinical practice, [[blood pressure]] is the most important modifiable [[risk factor]] of stroke; however many other risk factors, such as cigarette smoking cessation and treatment of atrial fibrillation with [[anticoagulant]] drugs, are important.
Risk factors for stroke include [[Old age|advanced age]], [[hypertension]] (high blood pressure), previous stroke or TIA ([[transient ischaemic attack]]), [[diabetes mellitus]], [[hypercholesterolemia|high cholesterol]], [[cigarette smoking]], [[atrial fibrillation]], [[migraine]]<ref>[http://headaches.about.com/od/migrainediseas1/a/mx_stroke_risk.htm headaches.about.com]</ref> with aura, and [[thrombophilia]]. In clinical practice, [[blood pressure]] is the most important modifiable [[risk factor]] of stroke; however many other risk factors, such as cigarette smoking cessation and treatment of atrial fibrillation with [[anticoagulant]] drugs, are important.

Revision as of 16:32, 11 November 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Risk factors for stroke include advanced age, hypertension (high blood pressure), previous stroke or TIA (transient ischaemic attack), diabetes mellitus, high cholesterol, cigarette smoking, atrial fibrillation, migraine[1] with aura, and thrombophilia. In clinical practice, blood pressure is the most important modifiable risk factor of stroke; however many other risk factors, such as cigarette smoking cessation and treatment of atrial fibrillation with anticoagulant drugs, are important.

Risk Factors

Risk factors of ischemic stroke may be divided into modifiable and non modifiable risk factors:[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]

Modifiable risk factors Non modifiable risk factors
Hypertension[2][3][28] Age >55 years [2][3][11]
Diabetes mellitus[2][3][28][29] Family history of ischemic stroke[9][10]
Atrial fibrillation[18][19][20][21] African American and hispanic race[2][3][30][31]
Coronary heart disease[2] Male gender[2][3]
Cigarette smoking[3][32][12] Genetic disorders[8][10][33]
Alcohal consumption[3] Previous history of stroke or TIA
Hyperhomocysteinemia[34][15]
Obesity[26][27]
Hyperlipidemia[3][35][36][14]
Hypothyroidism[17][18]
Oral contraceptive use [23][24]
Sedentary life style[22]
Hypercoagulable disorders[3][16]

References

  1. ↑ headaches.about.com
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Allen CL, Bayraktutan U (2008). "Risk factors for ischaemic stroke". Int J Stroke. 3 (2): 105–16. doi:10.1111/j.1747-4949.2008.00187.x. PMID 18706004.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Deoke A, Deoke S, Saoji A, Hajare S (2012). "Profile of modifiable and non-modifiable risk factors in stroke in a rural based tertiary care hospital - a case control study". Glob J Health Sci. 4 (3): 158–63. doi:10.5539/gjhs.v4n3p158. PMC 4776924. PMID 22980242.
  4. ↑ Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD; et al. (2006). "Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group". Circulation. 113 (24): e873–923. doi:10.1161/01.STR.0000223048.70103.F1. PMID 16785347.
  5. ↑ Awada A (2011). "[Primary and secondary prevention of ischemic stroke]". J Med Liban. 59 (4): 213–9. PMID 22746010.
  6. ↑ Hankey GJ (1999). "Stroke: how large a public health problem, and how can the neurologist help?". Arch Neurol. 56 (6): 748–54. PMID 10369318.
  7. ↑ Maredza M, Bertram MY, Gómez-Olivé XF, Tollman SM (2016). "Burden of stroke attributable to selected lifestyle risk factors in rural South Africa". BMC Public Health. 16: 143. doi:10.1186/s12889-016-2805-7. PMC 4751665. PMID 26869067.
  8. ↑ 8.0 8.1 Meschia JF, Worrall BB, Rich SS (2011). "Genetic susceptibility to ischemic stroke". Nat Rev Neurol. 7 (7): 369–78. doi:10.1038/nrneurol.2011.80. PMC 3932660. PMID 21629240.
  9. ↑ 9.0 9.1 Jood K, Ladenvall C, Rosengren A, Blomstrand C, Jern C (2005). "Family history in ischemic stroke before 70 years of age: the Sahlgrenska Academy Study on Ischemic Stroke". Stroke. 36 (7): 1383–7. doi:10.1161/01.STR.0000169944.46025.09. PMID 15933254.
  10. ↑ 10.0 10.1 10.2 Jerrard-Dunne P, Cloud G, Hassan A, Markus HS (2003). "Evaluating the genetic component of ischemic stroke subtypes: a family history study". Stroke. 34 (6): 1364–9. doi:10.1161/01.STR.0000069723.17984.FD. PMID 12714707.
  11. ↑ 11.0 11.1 Prabhakaran S, Wright CB, Yoshita M, Delapaz R, Brown T, DeCarli C; et al. (2008). "Prevalence and determinants of subclinical brain infarction: the Northern Manhattan Study". Neurology. 70 (6): 425–30. doi:10.1212/01.wnl.0000277521.66947.e5. PMC 2714050. PMID 17898325.
  12. ↑ 12.0 12.1 Peters SA, Huxley RR, Woodward M (2013). "Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes". Stroke. 44 (10): 2821–8. doi:10.1161/STROKEAHA.113.002342. PMID 23970792.
  13. ↑ Wilson PW, Hoeg JM, D'Agostino RB, Silbershatz H, Belanger AM, Poehlmann H; et al. (1997). "Cumulative effects of high cholesterol levels, high blood pressure, and cigarette smoking on carotid stenosis". N Engl J Med. 337 (8): 516–22. doi:10.1056/NEJM199708213370802. PMID 9262494.
  14. ↑ 14.0 14.1 Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM (2007). "Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women". JAMA. 298 (3): 309–16. doi:10.1001/jama.298.3.309. PMID 17635891.
  15. ↑ 15.0 15.1 Iso H, Moriyama Y, Sato S, Kitamura A, Tanigawa T, Yamagishi K; et al. (2004). "Serum total homocysteine concentrations and risk of stroke and its subtypes in Japanese". Circulation. 109 (22): 2766–72. doi:10.1161/01.CIR.0000131942.77635.2D. PMID 15159287.
  16. ↑ 16.0 16.1 Bushnell CD, Goldstein LB (2000). "Diagnostic testing for coagulopathies in patients with ischemic stroke". Stroke. 31 (12): 3067–78. PMID 11108774.
  17. ↑ 17.0 17.1 Remmel KS, Wanahita A, Moore K, Gruenthal M (2006). "Acute ischemic stroke and hypothyroidism". J Ky Med Assoc. 104 (5): 191–3. PMID 16734043.
  18. ↑ 18.0 18.1 18.2 Squizzato A, Gerdes VE, Brandjes DP, Büller HR, Stam J (2005). "Thyroid diseases and cerebrovascular disease". Stroke. 36 (10): 2302–10. doi:10.1161/01.STR.0000181772.78492.07. PMID 16179578.
  19. ↑ 19.0 19.1 Friberg L, Rosenqvist M, Lindgren A, Terént A, Norrving B, Asplund K (2014). "High prevalence of atrial fibrillation among patients with ischemic stroke". Stroke. 45 (9): 2599–605. doi:10.1161/STROKEAHA.114.006070. PMID 25034713.
  20. ↑ 20.0 20.1 Joundi RA, Cipriano LE, Sposato LA, Saposnik G, Stroke Outcomes Research Working Group (2016). "Ischemic Stroke Risk in Patients With Atrial Fibrillation and CHA2DS2-VASc Score of 1: Systematic Review and Meta-Analysis". Stroke. 47 (5): 1364–7. doi:10.1161/STROKEAHA.115.012609. PMID 27026630.
  21. ↑ 21.0 21.1 Fauchier L, Clementy N, Pelade C, Collignon C, Nicolle E, Lip GY (2015). "Patients With Ischemic Stroke and Incident Atrial Fibrillation: A Nationwide Cohort Study". Stroke. 46 (9): 2432–7. doi:10.1161/STROKEAHA.115.010270. PMID 26251249.
  22. ↑ 22.0 22.1 Buttar HS, Li T, Ravi N (2005). "Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation". Exp Clin Cardiol. 10 (4): 229–49. PMC 2716237. PMID 19641674.
  23. ↑ 23.0 23.1 Gillum LA, Mamidipudi SK, Johnston SC (2000). "Ischemic stroke risk with oral contraceptives: A meta-analysis". JAMA. 284 (1): 72–8. PMID 10872016.
  24. ↑ 24.0 24.1 Bousser MG, Kittner SJ (2000). "Oral contraceptives and stroke". Cephalalgia. 20 (3): 183–9. PMID 10997772.
  25. ↑ Slooter AJ, Rosendaal FR, Tanis BC, Kemmeren JM, van der Graaf Y, Algra A (2005). "Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke". J Thromb Haemost. 3 (6): 1213–7. doi:10.1111/j.1538-7836.2005.01442.x. PMID 15946211.
  26. ↑ 26.0 26.1 Suk SH, Sacco RL, Boden-Albala B, Cheun JF, Pittman JG, Elkind MS; et al. (2003). "Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study". Stroke. 34 (7): 1586–92. doi:10.1161/01.STR.0000075294.98582.2F. PMID 12775882.
  27. ↑ 27.0 27.1 Mitchell AB, Cole JW, McArdle PF, Cheng YC, Ryan KA, Sparks MJ; et al. (2015). "Obesity increases risk of ischemic stroke in young adults". Stroke. 46 (6): 1690–2. doi:10.1161/STROKEAHA.115.008940. PMC 4458137. PMID 25944320.
  28. ↑ 28.0 28.1 Romero JR, Morris J, Pikula A (2008). "Stroke prevention: modifying risk factors". Ther Adv Cardiovasc Dis. 2 (4): 287–303. doi:10.1177/1753944708093847. PMC 2729177. PMID 19124428.
  29. ↑ Jørgensen L, Jenssen T, Joakimsen O, Heuch I, Ingebretsen OC, Jacobsen BK (2004). "Glycated hemoglobin level is strongly related to the prevalence of carotid artery plaques with high echogenicity in nondiabetic individuals: the Tromsø study". Circulation. 110 (4): 466–70. doi:10.1161/01.CIR.0000136809.55141.3B. PMID 15249512.
  30. ↑ Howard VJ (2013). "Reasons underlying racial differences in stroke incidence and mortality". Stroke. 44 (6 Suppl 1): S126–8. doi:10.1161/STROKEAHA.111.000691. PMC 3784978. PMID 23709708.
  31. ↑ Grysiewicz RA, Thomas K, Pandey DK (2008). "Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors". Neurol Clin. 26 (4): 871–95, vii. doi:10.1016/j.ncl.2008.07.003. PMID 19026895.
  32. ↑ Wolf PA, D'Agostino RB, Kannel WB, Bonita R, Belanger AJ (1988). "Cigarette smoking as a risk factor for stroke. The Framingham Study". JAMA. 259 (7): 1025–9. PMID 3339799.
  33. ↑ Ockene IS, Miller NH (1997). "Cigarette smoking, cardiovascular disease, and stroke: a statement for healthcare professionals from the American Heart Association. American Heart Association Task Force on Risk Reduction". Circulation. 96 (9): 3243–7. PMID 9386200.
  34. ↑ Eikelboom JW, Hankey GJ, Anand SS, Lofthouse E, Staples N, Baker RI (2000). "Association between high homocyst(e)ine and ischemic stroke due to large- and small-artery disease but not other etiologic subtypes of ischemic stroke". Stroke. 31 (5): 1069–75. PMID 10797167.
  35. ↑ Yaghi S, Elkind MS (2015). "Lipids and Cerebrovascular Disease: Research and Practice". Stroke. 46 (11): 3322–8. doi:10.1161/STROKEAHA.115.011164. PMC 4624572. PMID 26451029.
  36. ↑ Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG (2008). "Nonfasting triglycerides and risk of ischemic stroke in the general population". JAMA. 300 (18): 2142–52. doi:10.1001/jama.2008.621. PMID 19001625.

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