Abstract P602: Stroke Risk Factors Among the Young Over Time in the GCNKSS

Background: Data from the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) have demonstrated stable or increasing stroke incidence rates in young adults with differences by sex and race, suggesting the need for targeted approaches to stroke prevention in the young. We aimed to describe trends over time in prevalence of stroke risk factors among adults ages 20-54 with stroke by sex and race. Methods: Cases of incident stroke (IS, ICH, SAH) occurring in those 20-54 years old and living in a 5-county area of southern Ohio/northern Kentucky were ascertained during 5 study periods (1993-1994, 1999, 2005, 2010, 2015). All physician-adjudicated inpatient events and a sampling of outpatient events were included, excluding nursing home events. Data on risk factors (hypertension, diabetes, obesity (BMI≥30), and high cholesterol) diagnosed prior to stroke were abstracted from medical records, and prevalence of each risk factor was reported over time in race/sex groups. Trends over time were examined using the Cochran-Armitage test. Results: Over the 5 study periods, 1204 incident strokes were included; 49% were women, 33% were black, and mean age was 46 (SD 7) years. Premorbid hypertension increased over time in Black women (48% in 1993/4 to 76% in 2015, p=0.005) but not in any other race/sex group (all p>0.05). Premorbid high cholesterol increased significantly in all race/sex groups (Figure, all p<0.05) except for White men (p=0.06). There were no significant trends over time in pre-stroke diagnoses of diabetes or obesity in any of the race/sex groups (Figure). Conclusions: Among patients aged 20-54 with incident stroke in a large population-based study, the change in the prevalence of hypertension and high cholesterol differed by sex and race, while obesity and diabetes were stable over time in all race/sex groups. Future research is needed to address risk factor control at a population level and to understand the role of undiagnosed pre-stroke risk factors in the young.

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947. Stroke demographics and risk factor profile in HIV infected individuals in Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1133 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S506-S506

Author(s):

Folusakin Ayoade ◽

Dushyantha Jayaweera

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Clinical Research ◽

Stroke Risk ◽

Research Network ◽

Categorical Variables ◽

People Living With Hiv ◽

Risk Factor Profile ◽

Stroke Risk Factors ◽

Living With Hiv

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures

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The Burden of Stroke in Pakistan

International Journal of Stroke ◽

10.1111/j.1747-4949.2008.00214.x ◽

2008 ◽

Vol 3 (4) ◽

pp. 293-296 ◽

Cited By ~ 10

Author(s):

Bhojo A. Khealani ◽

Mohammad Wasay

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Case Series ◽

Stroke Care ◽

Poor Control ◽

Stroke Incidence ◽

Treatment Practices ◽

Stroke Risk Factors ◽

The Subject ◽

Artery Disease

Epidemiologic literature on stroke burden, patterns of stroke is almost non existent from Pakistan. However, several hospital-based case series on the subject are available, mainly published in local medical journals. Despite the fact that true stroke incidence and prevalence of stroke in Pakistan is not known, the burden is assumed to be high because of highly prevalent stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, dyslipidemia and smoking) in the community. High burden of these conventional stroke risk factors is further compounded by lack of awareness, poor compliance hence poor control, and inappropriate management/treatment practices. In addition certain risk factors like rheumatic valvular heart disease may be more prevalent in Pakistan. We reviewed the existing literature on stroke risk factors in community, the risk factor prevalence among stroke patients, patterns of stroke, out come of stroke, availability of diagnostic services/facilities related to stroke and resources for stroke care in Pakistan.

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Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽

10.1161/str.45.suppl_1.tp136 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

George Howard ◽

Mary Cushman ◽

Maciej Banach ◽

Brett M Kissela ◽

David C Goff ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Multivariable Analysis ◽

The Elderly ◽

Stroke Risk Factors ◽

Age Related ◽

Increased Risk ◽

The Impact ◽

Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

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Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽

10.1161/str.44.suppl_1.ans6 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Dawn M Aycock ◽

Kenya D Kirkendoll ◽

Kisha C Coleman ◽

Karen C Albright ◽

Anne W Alexandrov

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Family History ◽

Perceived Control ◽

Stroke Risk ◽

Perceived Threat ◽

Stroke Risk Factor ◽

Stroke Risk Factors ◽

History Of ◽

Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

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Abstract 183: Depressive Symptoms and Incident Stroke in Black and White Participants in the REGARDS Study

Stroke ◽

10.1161/str.43.suppl_1.a183 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Audrey L Austin ◽

Michael G Crowe ◽

Martha R Crowther ◽

Virginia J Howard ◽

Abraham J Letter ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Depressive Symptoms ◽

Racial Differences ◽

Stroke Risk ◽

Depression Scale ◽

Stroke Incidence ◽

Blacks And Whites ◽

The Impact

Background and Purpose: Research suggests that depression may contribute to stroke risk independent of other known risk factors. Most studies examining the impact of depression on stroke have been conducted with predominantly white cohorts, though blacks are known to have higher stroke incidence than whites. The purpose of this study was to examine depressive symptoms as a risk factor for incident stroke in blacks and whites, and determine whether depressive symptomatology was differentially predictive of stroke among blacks and whites. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS), is a national, population-based longitudinal study designed to examine risk factors associated with black-white and regional disparities in stroke incidence. Among 30,239 participants (42% black) accrued from 2003-2007, excluding those lacking follow-up or data on depressive symptoms, 27,557 were stroke-free at baseline. As of the January 2011 data closure, over an average follow-up of 4.6 years, 548 incident stroke cases were verified by study physicians based on medical records review. The association between baseline depressive symptoms (assessed via the Center for Epidemiological Studies Depression scale, 4-item version) and incident stroke was analyzed with Cox proportional hazards models adjusted for demographic factors (age, race, and sex), stroke risk factors (hypertension, diabetes, smoking, atrial fibrillation, and history of heart disease), and social factors (education, income, and social network). Results: For the total sample, depressive symptoms were predictive of incident stroke. The association between depressive symptoms and stroke did not differ significantly based on race (Wald X 2 = 2.38, p = .1229). However, race-stratified analyses indicated that the association between depressive symptoms and stroke was stronger among whites and non-significant among blacks. Conclusions: Depressive symptoms were an independent risk factor for incident stroke among a national sample of blacks and whites. These findings suggest that assessment of depressive symptoms may warrant inclusion in stroke risk scales. The potential for a stronger association in whites than blacks requires further study.

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Knowledge and Perception of Stroke: A Population-Based Survey in Uganda

ISRN Stroke ◽

10.1155/2014/309106 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Jane Nakibuuka ◽

Martha Sajatovic ◽

Elly Katabira ◽

Edward Ddumba ◽

Jayne Byakika-Tusiime ◽

...

Keyword(s):

Risk Factors ◽

Population Survey ◽

Stroke Risk ◽

Large Population ◽

Population Based ◽

Traditional Healers ◽

Warning Signs ◽

Stroke Event ◽

Stroke Risk Factors ◽

Stroke Knowledge

Purpose. This study, designed to complement a large population survey on prevalence of stroke risk factors, assessed knowledge and perception of stroke and associated factors. Methods. A population survey was conducted in urban Nansana and rural Busukuma, Wakiso district, central Uganda. Adult participants selected by multistage stratified sampling were interviewed about selected aspects of stroke knowledge and perception in a pretested structured questionnaire. Results. There were 1616 participants (71.8% urban; 68.4% female; mean age: 39.6 years ± 15.3). Nearly 3/4 did not know any stroke risk factors and warning signs or recognize the brain as the organ affected. Going to hospital (85.2%) was their most preferred response to a stroke event. Visiting herbalists/traditional healers was preferred by less than 1%. At multivariable logistic regression, good knowledge of stroke warning signs and risk factors was associated with tertiary level of education (OR 4.29, 95% CI 2.13–8.62 and OR 5.96, 95% CI 2.94–12.06), resp.) and self-reported diabetes (OR 1.97, 95% CI 1.18–3.32 and OR 1.84, 95% CI 1.04–3.25), resp.). Conclusion. Knowledge about stroke in Uganda is poor although the planned response to a stroke event was adequate. Educational strategies to increase stroke knowledge are urgently needed as a prelude to developing preventive programmes.

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Is migraine a risk factor for pediatric stroke?

Cephalalgia ◽

10.1177/0333102415576222 ◽

2015 ◽

Vol 35 (14) ◽

pp. 1252-1260 ◽

Cited By ~ 26

Author(s):

Amy A Gelfand ◽

Heather J Fullerton ◽

Alice Jacobson ◽

Stephen Sidney ◽

Peter J Goadsby ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Ischemic Stroke ◽

Incidence Rate ◽

Stroke Risk ◽

Stroke Incidence ◽

Post Hoc Analysis ◽

Ischemic Stroke Risk ◽

Post Hoc

Importance Our understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk. Objective In this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). Design, setting, and participants Children ages 2–17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache. Main outcome measures Main outcome measures included stroke incidence rates and incidence rate ratios (IR). Results Among the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8–5.2). A post-hoc analysis of adolescents (12–17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2–9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2–2.0). Conclusions There was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent migraineurs.

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PROFIL FAKTOR-FAKTOR RISIKO PADA PASIEN STROKE YANG DIRAWAT INAP DI IRINA F NEUROLOGI RSUP PROF. Dr. R. D. KANDOU MANADO PERIODE JANUARI – OKTOBER 2012

e-CliniC ◽

10.35790/ecl.2.3.2014.5760 ◽

2014 ◽

Vol 2 (3) ◽

Author(s):

Rio Christanto ◽

Corry N. Mahama ◽

Melke J. Tumboimbela

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Risk Category ◽

Stroke Patients ◽

Stroke Incidence ◽

Stroke Risk Factors ◽

History Of ◽

Male Sex ◽

Acute Attacks ◽

Diabetes Melitus

Abstract: Stroke is a serious neurological disease, with acute attacks that can lead to death. Closely related to the occurrence of stroke risk factors possessed by the patient, especially if there are risk factors that are not addressed properly. Aim: To know the profile of risk factors in stroke patients hospitalized in neurology. irina F of RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Methods: The study descriptive with retrospective method is to collect all the data of patients who had been diagnosed with stroke in inpatient neurology irina F RSUP Prof. Dr. R. D. Kandou Manado among period january to october 2012. Results: The results showed that the highest percentage of stroke patients are in the age group 51-65 years (45.2%), male sex (51.2%), high risk category of hypertension (92.2%), risk category Low dyslipidemia ((73.1%), low risk of diabetes mellitus (83.8%), history of heart problems (40.2%), had a history of smoking (8.2%). Conclusion: There are three factors that influence the risk of stroke incidence is age, gender and hypertension Keywords: stroke, risk factors Abstrak: Stroke merupakan penyakit neurologi yang serius, dengan serangan akut yang dapat menyebabkan kematian. Terjadinya stroke berkaitan erat dengan faktor risiko yang dipunyai oleh penderita, terutama bila faktor risiko yang ada tidak ditanggulangi dengan baik. Tujuan: Mengetahui profil faktor-faktor risiko pada pasien stroke yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai oktober 2012. Metode: Penelitian deskriktif dengan metode retrospektif yaitu mengumpulkan semua data penderita yang telah didiagnosa dengan stroke yang di rawat inap di irina F neurologi RSUP Prof. Dr. R. D. Kandou Manado periode januari 2012 sampai Oktober 2012. Hasil: Hasil penelitian menunjukan bahwa persentase terbanyak pasien stroke berada pada golongan umur 51-65 tahun (45,2%), berjenis kelamin laki-laki (51,2%), kategori risiko tinggi hipertensi (92,2%), kategori risiko rendah dislipidemia ((73,1%), risiko rendah diabetes melitus (83,8%), riwayat atau kelainan jantung (40,2%), memiliki riwayat merokok (8,2%). Simpulan: Terdapat 3 faktor risiko yang berpengaruh terhadap kejadian stroke yaitu umur, jenis kelamin dan hipertensi Kata kunci: Stroke, faktor risiko

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Abstract TP203: Reducing Stroke Burden in Uganda

Stroke ◽

10.1161/str.48.suppl_1.tp203 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Mark Kaddumukasa ◽

Jane Nakibuuka ◽

James Kayima ◽

Elly Katabira ◽

Carol Blixen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Growth Patterns ◽

Warning Signs ◽

Clear Understanding ◽

Stroke Risk Factor ◽

Stroke Risk Factors ◽

Study Participants ◽

Stroke Knowledge

Background: Stroke is a neurological condition with rapidly increasing burden in many low- and middle-income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. Methods: A cross sectional survey was conducted in urban Mukono district in central Uganda. Through a systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception, using a pretested structured questionnaire. Results: Of the 440 study participants enrolled for this study nearly 52% correctly reported that stroke involves the brain, while 57% reported that stroke is preventable. Majority of the participants 75.7% reported stress as a contributing factor. Only 45.7% of the study participants reported hypertension as a risk factor. Only two (0.5%) study participants identified cigarette smoking as a stroke risk factor. Of the eighty six study participants with hypertension only 39.5% knew hypertension as a risk factor and only 10.7% knew three or more stroke risk factors. Conclusion: Stroke knowledge is poor in urban Uganda. Individuals with hypertension had poor knowledge regarding stroke in spite their high risk for stroke. Stress and hypertension are the leading perceived risk factors in our settings. While stress is highly reported as a stroke risk factor in this study hypertension is likely a more amenable and practical intervention target.

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Abstract P604: Incidentally-Discovered Asymptomatic Ischemic Lesions Identified Using Natural Language Processing Are Strong Risk Markers for Future Ischemic Stroke

Stroke ◽

10.1161/str.52.suppl_1.p604 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

David M Kent ◽

Lester Y Leung ◽

Yichen Zhou ◽

Patrick H Luetmer ◽

David F Kallmes ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Natural Language Processing ◽

Natural Language ◽

Language Processing ◽

Stroke Risk ◽

Risk Markers ◽

Stroke Risk Factors ◽

Over Time ◽

Major Stroke

Background: White matter disease (WMD) and silent brain infarction (SBI) are known to be risk markers for stroke. Nevertheless, the predictive value of these changes when seen incidentally on routinely-obtained neuroimages is unknown. Methods: In this retrospective cohort study, Kaiser Permanente-Southern California health plan enrollees aged ≥ 50 years old with a brain CT or MRI scan between 2009-2019 and without a prior history of ischemic stroke, transient ischemic attack, or dementia were identified. Natural language processing (NLP) was used to identify patients with SBI and WMD on the index neuroimaging report. We used Cox proportional hazards to estimate the risk of future ischemic stroke associated with the presence of SBI and of WMD, controlling for major stroke risk factors. Results: Among 262,875 individuals receiving brain neuroimaging, 13,154 (5.0%) and 78,330 (29.8%) had SBI and WMD, respectively. The Table below summarizes the crude stroke incidence rates. The crude hazard ratio (HR) was 3.40 (95% CI 3.25-3.56) for SBI and 2.63 (95% CI 2.54-2.71) for WMD. In the multivariable model controlling for all major stroke risk factors, the effect of SBI was found to be stronger in younger versus older patients and for MRI- versus CT-discovered lesions. With MRI, the average adjusted HR over time was 2.95 (95% CI 2.53-3.44) for those < age 65 and 2.15 (95% CI 1.91-2.41) for those ≥ age 65. With CT scan, the average adjusted HR over time was 2.48 (95%CI 2.19-2.81) for those < age 65 and 1.81 (95% CI 1.71-1.91) for those ≥ age 65. The adjusted HR associated with a finding of WMD was 1.76 (95% CI 1.69-1.82) and was not modified by age or imaging modality. The effect of SBI decreased gradually over time, while the effect of WMD remained constant. Conclusion: Incidentally-discovered SBI and WMD are common in patients ≥ age 50 and are associated with substantial increases in the risk of subsequent symptomatic stroke. The findings may represent an opportunity for stroke prevention.

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