Familial History of Stroke and Stroke Risk

Liao, Duanping; Myers, Richard H.; Hunt, Steven C.; Shahar, Eyal; Paton, Catherine; Burke, Gregory L.; Province, Michael A.; Heiss, Gerardo

doi:10.1161/01.str.28.10.1908

Cited by 185 publications

(131 citation statements)

References 12 publications

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“…Strong evidence for a genetic component in human stroke comes from twin and family studies (Brass et al, 1992;Bak et al, 2002;Liao et al, 1997). In a study of 300,000 subjects, risk factors such as smoking, a history of diabetes, hypertension, and coronary heart disease, did not alter stroke occurrence in people who had stroke events in previous generations of their family (Liao et al, 1997). Conflicting results regarding candidate gene studies for stroke emphasize the complexity of this multifactorial, complex disorder.…”

Section: Genetic Aspects Of Stroke and Head Traumamentioning

confidence: 99%

Pathophysiology of Cerebral Ischemia and Brain Trauma: Similarities and Differences

Bramlett

Dietrich

2004

J Cereb Blood Flow Metab

569

358

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Summary: Current knowledge regarding the pathophysiology of cerebral ischemia and brain trauma indicates that similar mechanisms contribute to loss of cellular integrity and tissue destruction. Mechanisms of cell damage include excitotoxicity, oxidative stress, free radical production, apoptosis and inflammation. Genetic and gender factors have also been shown to be important mediators of pathomechanisms present in both injury settings. However, the fact that these injuries arise from different types of primary insults leads to diverse cellular vulnerability patterns as well as a spectrum of injury processes. Blunt head trauma produces shear forces that result in primary membrane damage to neuronal cell bodies, white matter structures and vascular beds as well as secondary injury mechanisms. Severe cerebral ischemic insults lead to metabolic stress, ionic perturbations, and a complex cascade of biochemical and molecular events ultimately causing neuronal death. Similarities in the pathogenesis of these cerebral injuries may indicate that therapeutic strategies protective following ischemia may also be beneficial after trauma. This review summarizes and contrasts injury mechanisms after ischemia and trauma and discusses neuroprotective strategies that target both types of injuries.

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Section: Genetic Aspects Of Stroke and Head Traumamentioning

confidence: 99%

Pathophysiology of Cerebral Ischemia and Brain Trauma: Similarities and Differences

Bramlett

Dietrich

2004

J Cereb Blood Flow Metab

569

358

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“…Atherosclerosis is a multifactorial metabolic disorder that underlies various clinical cardiovascular diseases which are known to aggregate within families, such as coronary heart disease [1][2][3][4], myocardial infarction [2,3], and stroke [5]. Investigation of whether genetic factors influence a significant proportion of the interindividual variability in atherosclerosis is important in the search for susceptibility genes for these common disorders [6].…”

Section: Introductionmentioning

confidence: 99%

Heritability of carotid intima-media thickness: A twin study

Zhao¹,

Cheema²,

Bremner³

et al. 2008

Atherosclerosis

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Objective-To estimate the heritability of carotid intima-media thickness (IMT), a surrogate marker for atherosclerosis, independent of traditional coronary risk factors.Methods and Results-We performed a classical twin study of carotid IMT using 98 middleaged male twin pairs, 58 monozygotic (MZ) and 40 dizygotic (DZ) pairs, from the Vietnam Era Twin Registry. All twins were free of overt cardiovascular disease. Carotid IMT was measured by ultrasound. Bivariate and multivariate analyses were used to determine the association between traditional cardiovascular risk factors and carotid IMT. Intraclass correlation coefficients and genetic modeling techniques were used to determine the relative contributions of genes and environment to the variation in carotid IMT. In our sample, the mean of the maximum carotid IMT was 0.75 ± 0.11. Age, systolic blood pressure and HDL were significantly associated with carotid IMT. The intraclass correlation coefficient for carotid IMT was larger in MZ (0.66; 95% confidence interval [CI], 0.62-0.69) than in DZ twins (0.37; 95% CI, 0.29-0.44), and the unadjusted heritability was 0.69 (95% CI, 0.54-0.79). After adjusting for traditional coronary risk factors, the heritability of carotid IMT was slightly reduced but still of considerable magnitude (0.59; 95% CI, 0.39-0.73).Conclusion-Genetic factors have a substantial influence on the variation of carotid IMT. Most of this genetic effect occurs through pathways independent of traditional coronary risk factors.

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“…Although there has been a decline in the incidence of stroke in the Western population during the past three decades (Heart Disease and Stroke Statistics-2003 Update, American Heart Association), the burden of this disease has increased and is expected to rise in the South Asian countries (Bulatao et al 1992). In various epidemiological studies in families (Jousilahti et al 1997;Liao et al 1997) and in twins (Brass et al 1992;Bak et al 2002), genetic factors were found to be involved in the predisposition of stroke in conjunction with the other risk factors.…”

Section: Introductionmentioning

confidence: 99%

Association of gene polymorphism with genetic susceptibility to stroke in Asian populations: a meta-analysis

2006

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Stroke is a heterogeneous multifactorial disease and is thought to have a polygenic basis. Casecontrol studies on gene sequence variations have identified a number of potential genetic predisposition factors, but due to the conflicting results, uncertainty remains on the effect of these polymorphisms on risk for the development of stroke. To qualitatively and quantitatively assess the risk associated with different gene polymorphisms for stroke in Asian populations, we comprehensively searched and identified all the studies of association. Clinically overt case-control studies were selected only if neuroimaging had been used as the confirmatory measure for diagnosis of stroke. We performed a meta-analysis of the three most investigated genes, viz., methylenetetrahydrofolate reductase (MTHFR), apolipoprotein E (ApoE) and angiotensinconverting enzyme (ACE). Statistically significant association with stroke were identified for C677T polymorphism of MTHFR [random effects odds ratio (OR) = 1.47, 95% confidence interval (95% CI) 1.19, 1.82; P = 0.0004] and marginally significant association was detected with allele e 4 of ApoE (random effects OR = 1.47, 95% CI 1.00, 2.15; P = 0.049). The sensitivity analysis (exclusion of studies with controls not in HardyWeinberg equilibrium) revealed a significant association of stroke with the MTHFR C677T and ApoE e 4 alleles but showed no association with ACE gene insertion/ deletion polymorphism.

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Familial History of Stroke and Stroke Risk

Abstract: The increased risk of stroke among persons with a positive familial history of stroke compared with those without a familial history of stroke is consistent with the expression of genetic susceptibility, a shared environment, or both in the etiology of stroke.

Cited by 185 publications

References 12 publications

Pathophysiology of Cerebral Ischemia and Brain Trauma: Similarities and Differences

Pathophysiology of Cerebral Ischemia and Brain Trauma: Similarities and Differences

Heritability of carotid intima-media thickness: A twin study

Association of gene polymorphism with genetic susceptibility to stroke in Asian populations: a meta-analysis

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