Risk factors for lacunar infarction syndromes

You, Roger X.; McNeil, John J; O’Malley, Heather M.; Davis, Stephen M.; Donnan, Geoffrey A

doi:10.1212/wnl.45.8.1483

Cited by 131 publications

(75 citation statements)

References 23 publications

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“…15 Hypertension, diabetes, hypercholesterolemia, and current smoking were significantly more prevalent in northern Manhattan Hispanics and blacks than in whites. Lacunar stroke is associated with hypertension, diabetes, and smoking 13,24 ; extracranial atherosclerotic stroke is associated with male gender and smoking 25 ; and NOMAS has previously reported a relationship between hypercholesterolemia and diabetes and intracranial atherosclerotic stroke. 10 Consequently, the incidence of lacunar and intracranial and extracranial atherosclerotic stroke was higher in northern Manhattan black and Hispanic subjects than in whites.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics

et al. 2005

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Background-Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community. Methods and Results-A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100 000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09). Conclusions-The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.

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Section: Discussionmentioning

confidence: 99%

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics

et al. 2005

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Relationship Between Abdominal Visceral Fat and Lacunar Infarcts in Japanese Men

Nagura

Nakagawa

Miyanaga

et al. 2004

Circ J

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ypertension is the most important risk factor for lacunar infarcts [1][2][3][4][5][6] and although abdominal visceral fat accumulation is thought to be associated with cardiovascular risk factors such as hypertension, its relationship with lacunar infarcts has not been investigated in Japanese men. 7 Abdominal visceral fat accumulation is associated with diet, lack of physical activity, drinking alcohol, mental stress, and the aging process. [8][9][10][11][12] In Japan after the 1960s, dietary patterns and other factors changed rapidly with economic growth [13][14][15] and therefore it is likely that the contribution of abdominal visceral fat accumulation and other cardiovascular risk factors to the development of lacunar infarcts differs between generations. We conducted a crosssectional study to investigate the association of cardiovascular risk factors, including abdominal visceral fat accumulation, with lacunar infarcts detected on brain magnetic resonance imaging (MRI) among middle-aged and elderly Japanese men participating in a health checkup program. Methods SubjectsThe study subjects were 859 men aged 40-79 years (mean ± SD: 58.7±8.5) who underwent abdominal computed tomography (CT) and brain MRI as optional examinations during a health checkup at the Senri LC Health Evaluation Center of the Kansai Occupational Health Association, Osaka, Japan, from January, 1999 to May, 2003. The health examination included a self-administered questionnaire, the measurement of weight, height, and blood pressure, and laboratory examinations of blood chemistry. Of the 859 subjects, 637 were between 40 and 64 years old, and 222 were between 65 and 79 years old. The study was approved by the Ethics Board of Kyoto Prefectural University of Medicine. Examinations for Cardiovascular Risk FactorsThe self-administered questionnaire was used to ascertain the subjects' past history of stroke and coronary heart disease, medication use for hypertension, diabetes and hyperlipidemia, status of cigarette smoking (never, former and current), status of alcohol drinking (never, former, current drinkers of ethanol at 1-45 g/day and current drinkers of ethanol at ≥46 g/day) and symptoms of numbness or disturbances in fluent speech, skilful writing and smooth walking. The general physical examination was conducted by a physician. Height and weight in light clothing were measured and the body mass index (BMI: kg/m 2 ) was calculated. Three categories of obesity were made using the tertiles of BMI.Blood pressure was measured by trained nurses using standard mercury sphygmomanometers on the left arm of the seated participant after a 5 min rest. Hypertension was categorized according to the guideline of the Japanese Society of Hypertension, 2000: 16 (1) optimal and normal

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“…Cigarette smoking has been well-documented as a risk factor for ischemic stroke in general, with relative risks of 1.5 -5.7 [5]. It is also well-reported that smoking degrades carotid IMT [6], a well-known surrogate marker for atherosclerosis [7].…”

Section: Introductionmentioning

confidence: 99%