The contribution of potentially modifiable risk factors to acute ischemic stroke burden - Comparing young and older adults
Stroke is a leading cause of death and disability. In order to estimate the contribution of five modifiable risk factors to acute ischemic stroke (AIS) incidence in Israel, we conducted a case-control study based on first AIS cases aged 21–90 reported to the Israeli National Stroke Registry during 2...
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| Veröffentlicht in: | Preventive medicine 2022-02, Vol.155, p.106933-106933, Article 106933 |
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| creator | Libruder, Carmit Ram, Amit Hershkovitz, Yael Karolinsky, Dolev Tanne, David Bornstein, Natan M. Zucker, Inbar |
| description | Stroke is a leading cause of death and disability. In order to estimate the contribution of five modifiable risk factors to acute ischemic stroke (AIS) incidence in Israel, we conducted a case-control study based on first AIS cases aged 21–90 reported to the Israeli National Stroke Registry during 2014–2015, and controls from a national health survey conducted between 2013 and 2015. We calculated the population attributable risk (PAR) of each risk factor and the combined PAR for all risk factors (hypertension, diabetes, current smoking, obesity and hyperlipidemia), in all study population and by subgroups of young adults (age |
| doi_str_mv | 10.1016/j.ypmed.2021.106933 |
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•The population attributable risk of five modifiable risk factors for stroke was 80%.•Current smoking was the most contributing risk factor for stroke among young adults.•Hypertension was the most contributing risk factor for stroke among older adults.•Current smoking explains more stroke cases among young men, compared to young women.•Obesity explains more stroke cases among young women, compared to young men.</description><identifier>ISSN: 0091-7435</identifier><identifier>EISSN: 1096-0260</identifier><identifier>DOI: 10.1016/j.ypmed.2021.106933</identifier><identifier>PMID: 34954243</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Case-Control Studies ; Case-control study ; Diabetes Mellitus - epidemiology ; Humans ; Hypertension - complications ; Hypertension - epidemiology ; Ischemic Stroke ; Population attributable risk (PAR) ; Risk Factors ; Stroke - epidemiology ; Young Adult ; Young adults</subject><ispartof>Preventive medicine, 2022-02, Vol.155, p.106933-106933, Article 106933</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-db959e5e7e6f8eda2d1bcd228f13b2c1cc324aa7ba7aa54e21d656cca2dcbba73</citedby><cites>FETCH-LOGICAL-c359t-db959e5e7e6f8eda2d1bcd228f13b2c1cc324aa7ba7aa54e21d656cca2dcbba73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0091743521005065$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34954243$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Libruder, Carmit</creatorcontrib><creatorcontrib>Ram, Amit</creatorcontrib><creatorcontrib>Hershkovitz, Yael</creatorcontrib><creatorcontrib>Karolinsky, Dolev</creatorcontrib><creatorcontrib>Tanne, David</creatorcontrib><creatorcontrib>Bornstein, Natan M.</creatorcontrib><creatorcontrib>Zucker, Inbar</creatorcontrib><title>The contribution of potentially modifiable risk factors to acute ischemic stroke burden - Comparing young and older adults</title><title>Preventive medicine</title><addtitle>Prev Med</addtitle><description>Stroke is a leading cause of death and disability. In order to estimate the contribution of five modifiable risk factors to acute ischemic stroke (AIS) incidence in Israel, we conducted a case-control study based on first AIS cases aged 21–90 reported to the Israeli National Stroke Registry during 2014–2015, and controls from a national health survey conducted between 2013 and 2015. We calculated the population attributable risk (PAR) of each risk factor and the combined PAR for all risk factors (hypertension, diabetes, current smoking, obesity and hyperlipidemia), in all study population and by subgroups of young adults (age < 55) and older adults (age ≥ 55). The final analysis included 571, 577 and 500 matched pairs for all study population, young adults and older adults, respectively. Among young adults, current smoking and hypertension were the two most contributing risk factors for AIS, accounting for 33.6% (95% CI 27.3–39.9) and 28.9% (95% CI 22.1–35.7) of AIS cases, respectively. Among older adults, hypertension was the single most contributing risk factor for AIS and diabetes was the second most contributing risk factor for AIS, accounting for 64.9% (95% CI 57.3–72.5) and 25.7% (95% CI 17.5–33.9) of AIS cases, respectively. The combined PAR was significantly lower among young adults (PAR = 67.9%), compared with older adults (PAR = 80.7%). The combined PAR for all study population was 80.1% (95% CI 74.0–86.2), indicating that five common and modifiable risk factors explain ~80% of AIS incidence in Israel. Primary prevention strategies targeting these risk factors have the potential to drastically reduce stroke related morbidity and mortality.
•The population attributable risk of five modifiable risk factors for stroke was 80%.•Current smoking was the most contributing risk factor for stroke among young adults.•Hypertension was the most contributing risk factor for stroke among older adults.•Current smoking explains more stroke cases among young men, compared to young women.•Obesity explains more stroke cases among young women, compared to young men.</description><subject>Aged</subject><subject>Case-Control Studies</subject><subject>Case-control study</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - epidemiology</subject><subject>Ischemic Stroke</subject><subject>Population attributable risk (PAR)</subject><subject>Risk Factors</subject><subject>Stroke - epidemiology</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>0091-7435</issn><issn>1096-0260</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1v2zAQhomiRe04_QUFAo5Z5PJDoqyhQ2EkbYAAXZyZII-nmrYkKiQVwP31ketk7UICd8_xPT6EfOVszRlX3w7r09ijWwsm-FxRjZQfyJKzRhVMKPaRLBlreFGXslqQq5QOjHGuWPmZLGTZVKUo5ZL83e2RQhhy9HbKPgw0tHQMGYfsTdedaB-cb72xHdLo05G2BnKIieZADUwZqU-wx94DTTmGI1I7RYcDLeg29KOJfvhDT2GaTzM4GjqHkRo3dTldk0-t6RJ-ebtX5On-brf9VTz-_vmw_fFYgKyaXDjbVA1WWKNqN-iMcNyCE2LTcmkFcAApSmNqa2pjqhIFd6pSADMIdi7KFbm9vDvG8Dxhyrqfd8auMwOGKWmheFkrXoszKi8oxJBSxFaP0fcmnjRn-ixdH_Q_6fosXV-kz1M3bwGTPffeZ94tz8D3C4DzN188Rp3A4wDofETI2gX_34BXdByXfQ</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Libruder, Carmit</creator><creator>Ram, Amit</creator><creator>Hershkovitz, Yael</creator><creator>Karolinsky, Dolev</creator><creator>Tanne, David</creator><creator>Bornstein, Natan M.</creator><creator>Zucker, Inbar</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202202</creationdate><title>The contribution of potentially modifiable risk factors to acute ischemic stroke burden - Comparing young and older adults</title><author>Libruder, Carmit ; Ram, Amit ; Hershkovitz, Yael ; Karolinsky, Dolev ; Tanne, David ; Bornstein, Natan M. ; Zucker, Inbar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-db959e5e7e6f8eda2d1bcd228f13b2c1cc324aa7ba7aa54e21d656cca2dcbba73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Case-Control Studies</topic><topic>Case-control study</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - epidemiology</topic><topic>Ischemic Stroke</topic><topic>Population attributable risk (PAR)</topic><topic>Risk Factors</topic><topic>Stroke - epidemiology</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Libruder, Carmit</creatorcontrib><creatorcontrib>Ram, Amit</creatorcontrib><creatorcontrib>Hershkovitz, Yael</creatorcontrib><creatorcontrib>Karolinsky, Dolev</creatorcontrib><creatorcontrib>Tanne, David</creatorcontrib><creatorcontrib>Bornstein, Natan M.</creatorcontrib><creatorcontrib>Zucker, Inbar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Preventive medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Libruder, Carmit</au><au>Ram, Amit</au><au>Hershkovitz, Yael</au><au>Karolinsky, Dolev</au><au>Tanne, David</au><au>Bornstein, Natan M.</au><au>Zucker, Inbar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The contribution of potentially modifiable risk factors to acute ischemic stroke burden - Comparing young and older adults</atitle><jtitle>Preventive medicine</jtitle><addtitle>Prev Med</addtitle><date>2022-02</date><risdate>2022</risdate><volume>155</volume><spage>106933</spage><epage>106933</epage><pages>106933-106933</pages><artnum>106933</artnum><issn>0091-7435</issn><eissn>1096-0260</eissn><abstract>Stroke is a leading cause of death and disability. In order to estimate the contribution of five modifiable risk factors to acute ischemic stroke (AIS) incidence in Israel, we conducted a case-control study based on first AIS cases aged 21–90 reported to the Israeli National Stroke Registry during 2014–2015, and controls from a national health survey conducted between 2013 and 2015. We calculated the population attributable risk (PAR) of each risk factor and the combined PAR for all risk factors (hypertension, diabetes, current smoking, obesity and hyperlipidemia), in all study population and by subgroups of young adults (age < 55) and older adults (age ≥ 55). The final analysis included 571, 577 and 500 matched pairs for all study population, young adults and older adults, respectively. Among young adults, current smoking and hypertension were the two most contributing risk factors for AIS, accounting for 33.6% (95% CI 27.3–39.9) and 28.9% (95% CI 22.1–35.7) of AIS cases, respectively. Among older adults, hypertension was the single most contributing risk factor for AIS and diabetes was the second most contributing risk factor for AIS, accounting for 64.9% (95% CI 57.3–72.5) and 25.7% (95% CI 17.5–33.9) of AIS cases, respectively. The combined PAR was significantly lower among young adults (PAR = 67.9%), compared with older adults (PAR = 80.7%). The combined PAR for all study population was 80.1% (95% CI 74.0–86.2), indicating that five common and modifiable risk factors explain ~80% of AIS incidence in Israel. Primary prevention strategies targeting these risk factors have the potential to drastically reduce stroke related morbidity and mortality.
•The population attributable risk of five modifiable risk factors for stroke was 80%.•Current smoking was the most contributing risk factor for stroke among young adults.•Hypertension was the most contributing risk factor for stroke among older adults.•Current smoking explains more stroke cases among young men, compared to young women.•Obesity explains more stroke cases among young women, compared to young men.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34954243</pmid><doi>10.1016/j.ypmed.2021.106933</doi><tpages>1</tpages></addata></record> |
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| subjects | Aged Case-Control Studies Case-control study Diabetes Mellitus - epidemiology Humans Hypertension - complications Hypertension - epidemiology Ischemic Stroke Population attributable risk (PAR) Risk Factors Stroke - epidemiology Young Adult Young adults |
| title | The contribution of potentially modifiable risk factors to acute ischemic stroke burden - Comparing young and older adults |
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