Epidemiology of stroke and its subtypes in Chinese vs white populations

Ge²,

et al. 2015

Brain and Behavior

BackgroundMultiligand receptor for advanced glycation end products (RAGE), osteoprotegerin, and Golgb1 genes may be implicated in atherosclerosis and vascular diseases. Single nucleotide polymorphisms (SNPs) rs1035798 in RAGE gene, rs2073617 and rs2073618 in TNFRSF11B, and rs3732410 in Golgb1 will be investigated on whether there is an association with hemorrhagic stroke (HS) in Chinese population.MethodsA total of 600 subjects including 199 HS patients and 401 controls were assayed. These samples were divided into two groups: the ≤50 year and >50 year groups. Genotyping of SNPs was determined using the SEQUENOM MassARRAY matrix‐assisted laser desorption ionization–time‐of‐flight–mass spectrometry. The association between genotype and HS risk was evaluated by computing the odds ratio (OR) and 95% confidence interval (CI) with multivariate unconditional logistic regression analyses.ResultsOur data showed that in the ≤50 year group, the rs1035798 major allele homozygote C/C in RAGE gene was associated with an increased risk of HS, while Golgb1 rs3732410 minor allele homozygote G/G was associated with a decreased risk of HS. In the >50 year group, the major allele homozygote G/G of rs2073618 was found to be associated with an increased risk of HS.ConclusionsThe polymorphisms rs1035798 of RAGE gene, rs2073618 of TNFRSF11B, and rs3732410 of Golgb1 might be involved in the risk of HS at different stage of ages.

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Polymorphisms in three genes are associated with hemorrhagic stroke

Ge²,

et al. 2015

Brain and Behavior

“…The absolute excess would be expected to be bigger in individuals with pre-existing cerebrovascular disease 38 and in populations (such as Asia) where the underlying rates of haemorrhagic stroke are higher. 235 However, statin therapy has been found to reduce the overall risk of stroke in many different settings (including in people who have already had a stroke 38 or have hypertension 103 ) irrespective of the underlying risk of vascular disease. 32 For example, the increase in haemorrhagic stroke is outweighed by the reduction in the risk of ischaemic stroke, as well as in other occlusive vascular events and deaths, even among individuals with a 5-year risk of major vascular events below 10%.…”

Section: Probable Increases In Rates Of Haemorrhagic Strokementioning

confidence: 99%

Interpretation of the evidence for the efficacy and safety of statin therapy

et al. 2016

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms SummaryThis review is intended to help clinicians, patients and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomized controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment.Large-scale randomized trial evidence shows that statin therapy reduces the risk of heart attacks, ischaemic strokes and coronary revascularization procedures ("major vascular events") by about one quarter for each mmol/L reduction in low density lipoprotein (LDL) cholesterol during each year (after the first) that it continues to be taken. The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (e.g. atorvastatin 40 mg daily, costing about £2 per

“…66 Extensive epidemiological data demonstrate marked ethnic differences in stroke incidence and the distribution of subtypes. For example, intracranial stenosis and intracerebral haemorrhage are more frequent in Far East Asian populations compared with white populations, 67,68 and small-vessel disease is more common among individuals of African ancestry living in London, UK or in the USA than in white individuals living in the same countries. 47,69 However, few studies have been conducted in non-white populations, and more are needed.…”

Section: Sex and Ethnic Differencesmentioning

confidence: 99%

Mechanisms and treatment of ischaemic stroke—insights from genetic associations

Markus

Bevan

2014

Nat Rev Neurol

| The precise pathophysiology of ischaemic stroke is unclear, and a greater understanding of the different mechanisms that underlie large-artery, cardioembolic and lacunar ischaemic stroke subtypes would enable the development of more-effective, subtype-specific therapies. Genome-wide association studies (GWASs) are identifying novel genetic variants that associate with the risk of stroke. These associations provide insight into the pathophysiological mechanisms, and present opportunities for novel therapeutic approaches. In this Review, we summarize the genetic variants that have been linked to ischaemic stroke in GWASs to date and discuss the implications of these associations for both our understanding and treatment of ischaemic stroke. The majority of genetic variants identified are associated with specific subtypes of ischaemic stroke, implying that these subtypes have distinct genetic architectures and pathophysiological mechanisms. The findings from the GWASs highlight the need to consider whether therapies should be subtype-specific. Further GWASs that include large cohorts are likely to provide further insights, and emerging technologies will complement and build on the GWAS findings.