Population-Attributable Risks for Ischemic Stroke in a Community in South Brazil: A Case-Control Study

Mallmann, Adroaldo Basseggio; Fuchs, Sandra Cristina Pereira Costa; Gus, Miguel; Fuchs, Flávio Danni; Moreira, Leila Beltrami

doi:10.1371/journal.pone.0035680

Cited by 23 publications

(20 citation statements)

References 22 publications

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“…Using a methodology similar to the INTERSTROKE study, Mallmann and colleagues found that, in a community in South Brazil, the combination of hypertension, atrial fibrillation, left ventricular hypertrophy, the presence of carotid bruit, heavy smoking status, diabetes mellitus, alcohol abuse, low high-density lipoprotein cholesterol, and physical inactivity explained 98.9% of the ischemic stroke incidence. 28 According to the Prospective Urban and Rural Epidemiological (PURE) Study, the protective behaviors against the development of cardiovascular diseases (healthy diet, regular physical activity, not smoking) are adopted less frequently by populations living in low-and middle-income countries. 29 This pattern also seems to occur within Brazil, where studies have shown a higher prevalence of cardiovascular risk factors, mainly smoking, hypertension, and obesity in the lowest socioeconomic groups.…”

Section: Health Behaviors and Cardiovascular Risk Factorsmentioning

confidence: 99%

Cardiovascular Health in Brazil

et al. 2016

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O ur article reviews the current situation of cardiovascular diseases (CVD) in Brazil, focusing on the influence of socioeconomic status and regional variation in the epidemiology of CVD; and on current and novel strategies to confront CVD. After a brief description of the geographic, economic, and demographic aspects, the organizational aspects of the Brazilian healthcare system are explained. Next, risk factors and morbidity and mortality by CVD are described, followed by a discussion of strategies to confront CVD, regarding both prevention and treatment. Finally, the gaps in knowledge and suggested steps to overcome limitations are highlighted. Hence, this article aims to contribute to efforts to raise awareness concerning the CVD burden around the world, while highlighting initiatives that may promote the improvement of health and the reduction of disparities and current problems. Moreover, we hope it creates opportunities for interaction between researchers, clinicians, and health policy makers. Geographic, Economic, and Demographic DataBrazil is a country of continental dimensions exhibiting large differences in climate, genetic background, and lifestyle adopted in its distinct regions. It occupies 47% of South America, mainly in the tropical region, and has an estimated population of 202 768 562, with 51% women.1 The country is the fifth in land area, sixth in population, and currently the seventh economy in the world.2 Regarding income distribution, Brazil remains one of the world´s most unequal countries.2 Even though social disparities have decreased considerably over the past 14 years, 3 they are still unacceptable. The Gini coefficient for family income, a measure of inequality in income distribution ranging from 0 (complete equality) to 1 (complete inequality), declined from 0.59 in 2000 to 0.53 in 2012. The proportion of people living in poverty, defined as earning

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Section: Health Behaviors and Cardiovascular Risk Factorsmentioning

confidence: 99%

Cardiovascular Health in Brazil

et al. 2016

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“…[13][14][15][16] Of these, the INTERSTROKE study also reported results for younger stroke patients. 13 We examined 8 of the 10 risk factors associated with stroke in the INTERSTROKE study, a case-control study in 32 countries worldwide, including 13 447 cases with first-ever stroke and 13 472 controls.…”

Section: Comparison To Other Studiesmentioning

confidence: 99%

“…3,[9][10][11][12][13] The contribution of cardiovascular risk factors to the overall stroke risk was assessed previously. [13][14][15][16] Depending on the number of included risk factors, ≈90% of strokes can be explained by high blood pressure, smoking, obesity, diet, physical inactivity, diabetes mellitus, alcohol consumption, mental distress, heart disease, and lipid disorders. [13][14][15][16] However, these studies were mostly conducted in older populations, whereas stroke in the young is generally assumed to differ in risk factors and pathogenesis.…”

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confidence: 99%

“…[13][14][15][16] Depending on the number of included risk factors, ≈90% of strokes can be explained by high blood pressure, smoking, obesity, diet, physical inactivity, diabetes mellitus, alcohol consumption, mental distress, heart disease, and lipid disorders. [13][14][15][16] However, these studies were mostly conducted in older populations, whereas stroke in the young is generally assumed to differ in risk factors and pathogenesis. 3,17,18 The INTERSTROKE study recently provided evidence for the importance of established stroke risk factors for stroke in the young in a subgroup analysis.…”

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confidence: 99%

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Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Aigner

Grittner

Rolfs

et al. 2017

Stroke

196

154

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Background and Purpose-As stroke in young adults is assumed to have different etiologies and risk factors than in older populations, the aim of this study was to examine the contribution of established potentially modifiable cardiovascular risk factors to the burden of stroke in young adults. Methods-A German nationwide case-control study based on patients enrolled in the SIFAP1 study (Stroke In Young Fabry Patients) 2007 to 2010 and controls from the population-based GEDA study (German Health Update) 2009 to 2010 was performed. Cases were 2125 consecutive patients aged 18 to 55 years with acute first-ever stroke from 26 clinical stroke centers; controls (age-and sex-matched, n=8500, without previous stroke) were from a nationwide community sample. Adjusted population-attributable risks of 8 risk factors (hypertension, hyperlipidemia, diabetes mellitus, coronary heart disease, smoking, heavy episodic alcohol consumption, low physical activity, and obesity) and their combinations for all stroke, ischemic stroke, and primary intracerebral hemorrhage were calculated. Results-Low physical activity and hypertension were the most important risk factors, accounting for 59.7% (95% confidence interval, 56.3-63.2) and 27.1% (95% confidence interval, 23.6-30.6) of all strokes, respectively. All 8 risk factors combined explained 78.9% (95% confidence interval, 76.3-81.4) of all strokes. Population-attributable risks of all risk factors were similar for all ischemic stroke subtypes. Population-attributable risks of most risk factors were higher in older age groups and in men. Conclusions-Modifiable risk factors previously established in older populations also account for a large part of stroke in younger adults, with 4 risk factors explaining almost 80% of stroke risk. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.

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“…Recently, Malmann et al 24 observed in a population of hemiparetic patients that physical inactivity was determinant for new stroke events. The results of this study corroborate this finding, because in the first assessment, only 26.5% of the participants were classified as inactive, which contributes with the low found recurrence.…”

Section: Discussionmentioning

confidence: 99%

Estudo de seguimento da função motora de indivíduos pós-acidente vascular encefálico

Polese¹,

Pinheiro²,

Basílio³

et al. 2013

Fisioter. Pesqui.

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| The aim of this study was to characterize and analyze changes in the variables related to the motor function of chronic hemiparetic patients after a period of seven years. The demographic and clinical data of the participants, who were initially assessed in 2003, were collected by telephone. All individuals were invited to participate in the reassessments, which included data related to respiratory strength, functional performance, physical ability, and physical activity levels. Descriptive statistics, Wilcoxon or paired t-tests were used for analyses. Out of the 101 hemiparetic partcipants, who were initially assessed in 2003, 65 subjects or their relatives were contacted by telephone; 35 (64.5±10. 6 years) answered the questions by telephone, 8 passed away, and 22 (56.8±13.3 years) were physically assessed. After a mean follow up of seven years, none of the physically assessed variables showed significant differences between the two assessments (0. 08

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Population-Attributable Risks for Ischemic Stroke in a Community in South Brazil: A Case-Control Study

Cited by 23 publications

References 22 publications

Cardiovascular Health in Brazil

Cardiovascular Health in Brazil

Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Estudo de seguimento da função motora de indivíduos pós-acidente vascular encefálico

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