scholarly journals Stroke Epidemiology in Oceania: A Review

2021 ◽  
Vol 55 (1) ◽  
pp. 1-10
Author(s):  
Narayanaswamy Venketasubramanian
Keyword(s):  
Risk Factors ◽  
Common Factor ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Vascular Risk Factors ◽  
World Health ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Life Years ◽  
Stroke Epidemiology

Background and Purpose: Oceania, comprising the regions Australasia, Melanesia, Micronesia, and Polynesia, is home to 42 million living in 8.5 million square kilometres of land. This paper comprises a review of the epidemiology of stroke in countries in this region. Methods: Information on epidemiology of stroke in Oceania was sought from data from the Global Burden of Disease (GBD) study (incidence, mortality, incidence:mortality ratio [IMR], prevalence, disability-adjusted life-years [DALYs] lost due to stroke, and subtypes), World Health Organization (WHO) (vascular risk factors in the community), and PubMed (incidence, prevalence, and stroke subtypes). Data were analyzed by region to allow inter-country comparison within each region. Results: In 2010, age- and sex-standardized stroke mortality rates were lowest in Australasia (29.85–31.67/100,000) and highest in Melanesia and Micronesia (56.04–187.56/100,000), with wide ranges especially in Melanesia. Incidence rates were lowest in Australasia (101.36–105.54/100,000), similarly high elsewhere. Standardized IMR (0.98–3.39) was the inverse of the mortality rates and mirrored the prevalence rates (202.91–522.29/100,000). DALY rates (398.22–3,781.78/100,0000) mirrored the mortality rates. Stroke risk factors show a variable pattern – hypertension is generally the most common medical risk factor among males (18.0–26.6%), while among females, diabetes mellitus is the most common in Micronesia and Polynesia (21.5–28.4%). Among the lifestyle factors, current smoking is the most common in Melanesia among males, while obesity is generally the most common factor among females. Ischaemic stroke comprises 70% of stroke subtypes. Trend data show significant falls in standardized mortality rates and DALYs in most regions and falls in incidence in almost all countries. There is significant economic impact, particularly due to young strokes; some ethnicities are at higher risk than others, for example, Maoris and Pacific Islanders. Conclusions: Stroke is a major healthcare problem in Oceania. Variations in stroke epidemiology are found between countries in Oceania. Data are lacking in some; more research into the burden of stroke in Oceania is needed. With the expected increase in life expectancy and vascular risk factors, the burden of stroke in Oceania will likely rise. Some of the disparities in stroke burden may be addressed by great investment in healthcare.

Hyperhomocysteinemia: Relationship to vascular risk factors and stroke subtypes

1999 ◽  
Vol 8 (4) ◽  
pp. 280
Author(s):  
Abbur Rekha ◽  
Souvik Sen ◽  
Anand Vaishnav ◽  
Mohamed Ibrahim ◽  
Piero Verro
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtypes

scholarly journals Prevalence of the Frank’s sign by aetiopathogenic stroke subtype: A prospective analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261080
Author(s):  
Laura Sánchez-Cirera ◽  
Saima Bashir ◽  
Adina Ciscar ◽  
Carla Marco ◽  
Verónica Cruz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Haemorrhagic Stroke ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Cross Sectional ◽  
Stroke Subtypes ◽  
Artery Disease

Background and purpose The Frank’s sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank’s sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Methods Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank’s sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. Results The Frank’s sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank’s sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank’s sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank’s sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. Conclusion The Frank’s sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank’s sign.

scholarly journals Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

2015 ◽  
Vol 133 (3) ◽  
pp. 202-207 ◽  
Author(s):  
A. Nacu ◽  
A. Fromm ◽  
K. M. Sand ◽  
U. Waje‐Andreassen ◽  
L. Thomassen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Vascular Risk Factors ◽  
Age Dependency ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Western Norway

scholarly journals Trends in stroke subtypes and vascular risk factors in a stroke center in China over 10 years

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Danyang Tian ◽  
Qiong Yang ◽  
Quan Dong ◽  
Nan Li ◽  
Bernard Yan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Stroke Center

Are Vascular Risk Factors Associated With Post-Stroke Depressive Symptoms?

2011 ◽  
Vol 24 (4) ◽  
pp. 215-221 ◽  
Author(s):  
Gayla Tennen ◽  
Nathan Herrmann ◽  
Sandra E. Black ◽  
Karen S. Levy ◽  
Jaclyn Cappell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Vascular Risk Factors ◽  
World Health ◽  
Stroke Severity ◽  
Vascular Risk ◽  
Post Stroke ◽  
Health Organization

Objective: Vascular risk factors (VRFs) have been associated with stroke and cognitive impairment, however, the role of VRFs in predicting post-stroke depression (PSD) has not been assessed. The objective of the current study was to determine whether VRFs are associated with the risk of PSD in an acute stroke population. Methods: In this observational study, patients meeting World Health Organization MONICA Project and National Institute of Neurological Disorders and Stroke criteria for stroke were eligible. Patients were assessed for depression, cognition, and stroke severity, and VRF and demographic information were obtained. Results: A total of 102 patients were recruited within 4 months post-stroke. Using a score of ≥16 on the Center for Epidemiological Studies Depression scale to determine depressive symptoms, 38 patients (age 72.1 ± 15.6, 44.7% male) screened positive for depressive symptoms and 64 (age 70.1 ± 13.6, 51.6% male) screened negative. Analysis of VRFs showed that only hypertension ( P = .044) independently predicted the presence of depressive symptoms (χ2 = 4.742, P = .029, Nagelkerke R2 = .062). Conclusions: Hypertension was associated with post-stroke depressive symptoms, while there was no relationship between PSD and other VRFs. Hypertension may have a greater impact than other VRFs on mood following stroke and may have a role in prevention and treatment of PSD.

The Spectrum of Cerebrovascular Disease and Associated Cognitive Decline

2019 ◽  
pp. 574-599
Author(s):  
Victoria J. Williams ◽  
Steven E. Arnold ◽  
David H. Salat
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Cognitive Decline ◽  
Vascular Dementia ◽  
Structure And Function ◽  
Vascular Risk Factors ◽  
Vascular Health ◽  
Vascular Risk ◽  
And Function

Throughout the lifespan, common variations in systemic health and illness contribute to alterations in vasculature structure and function throughout the body, significantly increasing risk for cardiovascular and cerebrovascular disease (CVD). CVD is a prevalent cause of mortality in late life; it also promotes brain alterations, contributing to cognitive decline and, when severe, vascular dementia. Even prior to diseased states, individual variation in CVD risk is associated with structural and functional brain alterations. Yet, how cumulative asymptomatic alterations in vessel structure and function contribute to more subtle changes in brain tissue integrity and function that emerge in late life is unclear. Finally, vascular risk factors are associated with the clinical progression of neurodegenerative diseases such as Alzheimer’s disease (AD); however, recent theory posits that vascular degeneration may serve a contributory role in these conditions. This chapter reviews how lifespan changes in vascular health contribute to degenerative changes in neural tissue and the subsequent development of cognitive impairment and/or vascular dementia. It first discusses associations between vascular risk factors and cognition and also how declining vascular health may lead to cognitive impairment and dementia. Next, it identifies basic aspects of cerebrovascular anatomy and physiology sustaining tissue health and discusses how vulnerabilities of this system contribute to neurodegenerative changes. Finally, it reviews evidence of vascular contributions to AD and presents ideas for future research to better understand the full spectrum of cerebrovascular contributions to brain aging, cognitive decline, and dementia.

scholarly journals The impact of vascular risk factors on the thickness and volume of the choroid in AMD patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elżbieta Krytkowska ◽  
Aleksandra Grabowicz ◽  
Katarzyna Mozolewska-Piotrowska ◽  
Zofia Ulańczyk ◽  
Krzysztof Safranow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Vascular Risk ◽  
Average Volume ◽  
Central Ring ◽  
Age Related ◽  
The Impact ◽  
Wet Amd

AbstractDisturbances in choroidal microcirculation may lead to the onset and progression of age-related macular degeneration (AMD). We aimed to assess changes in the choroidal volume and thickness in the macular region in AMD eyes and to investigate whether coexisting vascular risk factors alter choroidal status. We enrolled 354 AMD patients (175 dry, 179 wet AMD) and 121 healthy controls. All participants underwent a complete ophthalmologic examination and assessment of choroidal thickness and volume. A multivariate analysis adjusted for age, sex, and smoking status revealed that wet AMD was an independent factor associated with higher average thickness of the central ring area (ATC) and average volume of the central ring area (AVC) and lower choroidal vascularity index (CVI) compared to controls (β =  + 0.18, p = 0.0007, β =  + 0.18, p = 0.0008, respectively) and to dry AMD (β =  + 0.17, p = 0.00003 for both ATC and AVC and β =  − 0.30 p < 0.0001 for CVI). ATC, AVC and average volume (AV) were lower in AMD patients with hypertension and ischaemic heart disease (IHD). The duration of hypertension was inversely correlated with ATC, AVC and AV (Rs =  − 0.13, p < 0.05; Rs =  − 0.12; p < 0.05, Rs =  − 0.12; p < 0.05, respectively) while IHD duration negatively correlated with AV (Rs =  − 0.15, p < 0.05). No such associations were observed in the control group. Our findings show that the choroidal vascular system in eyes with AMD is much more susceptible to damage in the presence than in the absence of systemic vascular disease.

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