Abstract P614: Effect Sizes of Vascular Risk Factors for Stroke Occurrence by Age Among West Africans

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
FRED S SARFO ◽  
Onoja Akpa ◽  
Joshua Akinyemi ◽  
Albert Akpalu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Age ◽  
Meat Consumption ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Effect Sizes ◽  
Modifiable Risk Factors ◽  
Age Group ◽  
Vascular Risk ◽  
Elderly Age

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.

scholarly journals Potentially Modifiable Risk Factors in the Development of Alzheimer’s Disease

US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 18 ◽  
Author(s):  
Simon Forstmeier ◽  
Andreas Maercker ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Emotional Health ◽  
Social Activity ◽  
Empirical Support ◽  
Epidemiological Studies ◽  
Vascular Risk Factors ◽  
Modifiable Risk Factors ◽  
Vascular Risk

This article summarises empirical findings on major potentially modifiable risk factors in the development of Alzheimer’s disease (AD), drawing on data from longitudinal epidemiological studies on the incidence of AD or any-cause dementia. Risk factors investigated to date include cognitive ability, motivational ability, emotional health, physical activity, social activity and social network, vascular risk factors and nutrition. The authors find most empirical support for two main clusters of risk factors that also represent potential targets for prevention. First, an active and stimulating lifestyle including cognitive, social, and physical activities reduces the risk of AD. Second, the absence of vascular risk factors such as diabetes, hypertension, hypercholesterol and obesity reduces the risk of AD. More prevention trials are warranted to investigate the preventative effects of an active and stimulating lifestyle on the one hand, and vascular health on the other, in delaying the onset of AD or slowing its progression.

scholarly journals Differing Pattern of Ambulatory Blood Pressure in Very Elderly Men Expresses Dynamics in Atherosclerotic Load in the Senescence

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Arkadiusz Siennicki-Lantz ◽  
Sölve Elmståhl
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Measurement ◽  
Ankle Brachial Index ◽  
The Elderly ◽  
Population Based ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Pressure Development

To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM) in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM.Results. At age 68, hypertension and high clinic blood pressure (CBP) did not predict ABPM level. Smoking and low ankle-brachial index (ABI) predicted higher ABPM variability and pulse pressure (PP), but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP.Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status.

scholarly journals White matter hyperintensities across the adult lifespan: relation to age, Aβ load, and cognition

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Antoine Garnier-Crussard ◽  
Salma Bougacha ◽  
Miranka Wirth ◽  
Claire André ◽  
Marion Delarue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Memory ◽  
Executive Functions ◽  
White Matter Hyperintensities ◽  
Vascular Risk Factors ◽  
Age Group ◽  
Vascular Risk ◽  
Middle Aged ◽  
Adult Lifespan ◽  
Middle Aged Adults

Abstract Background White matter hyperintensities (WMH) are very frequent in older adults and associated with worse cognitive performance. Little is known about the links between WMH and vascular risk factors, cortical β-amyloid (Aβ) load, and cognition in cognitively unimpaired adults across the entire lifespan, especially in young and middle-aged adults. Methods One hundred and thirty-seven cognitively unimpaired adults from the community were enrolled (IMAP cohort). Participants underwent (i) a comprehensive neuropsychological assessment of episodic memory, processing speed, working memory, and executive functions; (ii) brain structural T1 and FLAIR MRI scans used for the automatic segmentation of total and regional (frontal, parietal, temporal, occipital, and corpus callosum) WMH; and (iii) a Florbetapir-PET scan to measure cortical Aβ. The relationships of total and regional WMH to age, vascular risk factors, cortical Aβ, and cognition were assessed within the whole sample, but also splitting the sample in two age groups (≤ or > 60 years old). Results WMH increased with age across the adult lifespan, i.e., even in young and middle-aged adults. Systolic blood pressure, diastolic blood pressure, and glycated hemoglobin were all associated with higher WMH before, but not after, adjusting for age and the other vascular risk factors. Higher frontal, temporal, and occipital WMH were associated with greater Aβ, but this association was no longer significant when adjusting for age and vascular risk factors. Higher total and frontal WMH were associated with worse performance in executive functions, with no interactive effect of the age group. In contrast, there was a significant interaction of the age group on the link between WMH and working memory, which was significant within the subgroup of young/middle-aged adults only. Adding cortical Aβ load in the models did not alter the results, and there was no interaction between WMH and Aβ on cognition. Conclusion WMH increased with age and were associated with worse executive functions across the adult lifespan and with worse working memory in young/middle-aged adults. Aβ load was weakly associated with WMH and did not change the relationship found between WMH and executive functions. This study argues for the clinical relevance of WMH across the adult lifespan, even in young and middle-aged adults with low WMH.

scholarly journals Neurosarcoidosis Presenting With Recurrent Strokes

2016 ◽  
Vol 7 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Naheed Raza ◽  
Karisa C. Schreck
Keyword(s):  
Risk Factors ◽  
Young People ◽  
Elderly Patients ◽  
Classification Scheme ◽  
The Elderly ◽  
Secondary Stroke Prevention ◽  
High Grade ◽  
Age Group ◽  
Vascular Risk ◽  
Recurrent Strokes

Neurosarcoidosis is a rare but important cause of stroke as it is treatable. Cases reported thus far have primarily been in young people who are relatively healthy. Here we report the case of a 73-year-old woman presenting with recurrent strokes and high-grade intracranial stenosis caused by probable neurosarcoidosis. This is unique as neurosarcoidosis is not usually considered as an etiology for recurrent strokes in our patient’s age-group. We review and categorize published cases of neurosarcoidosis causing stroke and describe a classification scheme for certainty of diagnosis. Given the implications of this diagnosis for secondary stroke prevention, we recommend that neurosarcoidosis be considered in the differential for patients with few vascular risk factors, recurrent strokes refractory to medical treatment, or possible vasculitis even in the elderly patients.

scholarly journals Association between cerebral small vessel diseases and mild parkinsonian signs in the elderly with vascular risk factors

2016 ◽  
Vol 26 ◽  
pp. 29-34 ◽  
Author(s):  
Jun Hatate ◽  
Kaori Miwa ◽  
Mari Matsumoto ◽  
Tsutomu Sasaki ◽  
Yoshiki Yagita ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Vascular Risk ◽  
Cerebral Small Vessel Diseases

scholarly journals Study of the positivity of spontaneous and directed diagnosis of leukoaraiosis in the elderly by cranial computerized tomography, and its correlation with cognitive defi cit and cardiovascular risk factors

2007 ◽  
Vol 65 (4b) ◽  
pp. 1134-1138
Author(s):  
Mauricio de Miranda Ventura ◽  
Antonio Carlos de Paiva Melo ◽  
Henrique Carrete Jr ◽  
Ricardo Vieira Botelho
Keyword(s):  
Risk Factors ◽  
Cognitive Performance ◽  
Computerized Tomography ◽  
Positive Association ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Cognitive Tests ◽  
Vascular Risk ◽  
Significant Difference ◽  
Cranial Computerized Tomography

OBJECTIVE: To evaluate the prevalence of leukoaraiosis (LA) and its correlation with vascular risk factors and the cognitive performance of elderly patients. METHOD: 78 patients were randomly selected and submitted to clinic-laboratorial evaluation for vascular risk factors. Two cognitive tests were performed. All patients were submitted to cranial computerized tomography (CT), which was analyzed in two situations: the spontaneous and the directed way. RESULTS: There was no statistically significant difference between the prevalence of spontaneous and the directed diagnoses of LA (20.5 and 18%, respectively). The presence of LA was not significantly correlated with cognitive impairment. Only age was positively associated with LA. CONCLUSION: Cranial CT is a trustworthy method for the diagnosis of LA. Only age showed a positive association. No clinical implications were found, concerning the cognitive performance of the patients.

scholarly journals Evaluation of APOE Genotype and Vascular Risk Factors As Prognostic and Risk Factors for Alzheimer’s Disease and Their Influence On Age of Symptoms Onset

2019 ◽  
Vol 7 (4) ◽  
pp. 516-520 ◽  
Author(s):  
Gabriela Novotni ◽  
Milena Jakimovska ◽  
Dijana Plaseska-Karanfilska ◽  
Nikolina Tanovska ◽  
Igor Kuzmanovski ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Age Of Onset ◽  
Disease Onset ◽  
Vascular Risk Factors ◽  
Modifiable Risk Factors ◽  
Vascular Risk ◽  
Awareness Campaigns

BACKGROUND: Alzheimer’s disease (AD), the most common cause of dementia, is evolving to become a threatening epidemy of the 21st century. Only 21% of the predicted number of AD patients in Macedonia have been diagnosed and treated, which means that almost 80% are underdiagnosed or misdiagnosed. Apolipoprotein E gene (APOE) is recognised as the strongest genetic risk factor for sporadic AD. Whether and when Alzheimer’s disease develops, depends on the very complex interaction between genetic and modifiable risk factors. It has been known that vascular factors like hypertension, diabetes mellitus, hypercholesterolemia and obesity increase the risk of developing both AD, vascular dementia and mixed AD and vascular pathology AIM: This study aims to evaluate the influence of APOEε4 allele presence and modifiable vascular risk factors (hypertension, diabetes mellitus and dyslipidemia) as prognostic and risk factors for AD and their influence on the age of onset of AD symptoms among 144 AD patients from Macedonia. MATERIAL AND METHODS: Study group of a total of 144 patients diagnosed with AD was evaluated. APOE genotyping was performed using APOE haplotype-specific sequence specific-primer (SSP)-PCR (Polymerase Chain Reaction) methodology. The non-standardized questionnaire was used to obtain information about demographics, lifestyle and modifiable risk factors that could influence disease onset and phenotype. RESULTS: Statistically significant association was found between the presences of APOEε4 allele in AD group versus controls. The presence of APOEε4 allele increases the risk of developing AD in a 3-fold manner. The average age of disease onset in the ε4 carrier group was 67.2 ± 8.3 and in the ε4 non-carrier group 69.7 ± 9.4. This confirms that the presence of APOEε4 allele shifts towards earlier disease onset, though the difference is not statistically significant. Out of the vascular risk factors, only hypertension was significantly associated with earlier AD onset. Out of total 144 patients, in 22.9% the first symptom onset was before the age of 65, that can be considered as early onset Alzheimer’s Disease (EOAD), which is much higher than 5% for EOAD as most of the studies report. CONCLUSIONS: The average age of disease onset of 68.4 years could be considered earlier than the average age of AD onset worldwide. Out of all the vascular risk factors analysed in this study, only hypertension and dyslipidemia were found to significantly increase the risk for developing AD and only the presence of hypertension influences the age of onset, shifting towards earlier disease onset. Public awareness campaigns should be organised to influence general population knowledge about Alzheimer’s disease, early recognition and the influence of modifiable vascular risk factors.

THE VASCULAR RISK FACTORS ASSOCIATED WITH ANTIPLATELET RESISTANCE IN ISCHEMIC STROKE PATIENTS

2020 ◽  
pp. 144-147
Author(s):  
RIZALDY TASLIM PINZON ◽  
BULAN MARCHELLIA WIJAYA
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Vascular Risk Factors ◽  
Ischemic Heart ◽  
Vascular Risk ◽  
Stroke Patients ◽  
Elderly Age ◽  
Factors Associated

Objectives: This research is to measure the prevalence rate of antiplatelet resistance in ischemic stroke patients and measure the vascular risk factors associated with antiplatelet resistance in patients with ischemic stroke. Methods and Subjects: This was a cross-sectional study with the number of respondents in this study amounted to 155 patients who all had ischemic stroke disease at Bethesda Hospital in Yogyakarta Indonesia used stroke registry to complete the data of the risk factors. VerifyNow method is used to measure the responsiveness of antiplatelet therapy. Results: Among the 155 patients with ischemic stroke, 45 were women (29%), 110 were men (71%), and the elderly (age more than 60 years old) in 81 patients. In total 155 patients with ischemic stroke, 106 of them have hypertensive, with diabetes are 19 patients, dyslipidemia is 90 patients, and ischemic heart disease in 13 patients. The prevalence of antiplatelet resistance in risk factors, for age more than 60 years, is 21 patients (25%, RR=1.06, *p=0.96), in diabetes is 7 patients (36%, RR=1.17, **p=0.74), dyslipidemia is 19 patients (21%, RR=0.68, ***p=0.24), and ischemic heart disease is four patients (30%). Among 127 patients, 22% (28 patients) had aspirin resistance, while from 42 patients, 26.2% (11 patients) were resistant to clopidogrel. Conclusion: Antiplatelet resistance is common in ischemic stroke patients. One of five patients treated with antiplatelet showed non-responsiveness. Vascular risk factors do not increase the risk of antiplatelet resistance in ischemic stroke patients.

Abstract TP166: The Topmost Modifiable Risk Factors for Stroke Among People of African Ancestry

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mayowa O Owolabi ◽  
Fred S Sarfo ◽  
Onoja Akpa ◽  
Mulugeta Gebregziabher ◽  
Rufus Akinyemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Ancestry ◽  
Vascular Risk Factors ◽  
Systematic Evaluation ◽  
Modifiable Risk Factors ◽  
Large Artery ◽  
Vascular Risk ◽  
Geographical Variations ◽  
Catchment Areas ◽  
The Impact

Background: Regional and geographical variations exist in stroke burden and risk factor distribution. The unique and dominant risk factors for stroke among people of African ancestry where the burden of stroke is escalating, are poorly understood. Such information is crucial in prioritizing tailor-made interventions to tackle the menace of stroke in developing countries. Purpose: We aimed to identify and quantify the contributions of the topmost modifiable risk factors for stroke occurrence in people of African ancestry within the context of the Stroke Investigative Research and Educational Network (SIREN), the largest study of stroke in Africa. Methods: The SIREN study is an ongoing, multicenter, case-control study involving several sites in Nigeria and Ghana. Cases included adults aged >18 years with first clinical stroke within 8 days of current symptom onset with CT scan confirmation. Controls were stroke-free adults, mostly from the communities in the catchment areas of the SIREN hospitals where cases were recruited. A systematic evaluation of traditional vascular risk factors as well as lifestyle and behavioral factors were assessed for cases and controls. Results: 1,638 cases and 1,653 controls with mean ages of 58.52 and 57.76 years respectively were recruited. Ischemic and hemorrhagic stroke types constituted 62.4% and 36.1% of stroke respectively. Among ischemic stroke subjects, 45.7%, 36.3%, 13.6%, 1.0% and 3.4% had small-vessel, large-artery atherosclerosis, cardio-embolic, others and unknown subtypes according to the TOAST classification. Leading vascular risk factors identified among stroke subjects compared with controls were hypertension- 79.3% vs 34.6%, p<0.001; Dyslipidemia 20.8% vs 6.6%, p<0.001; Diabetes mellitus- 24.4% vs 12.8% and history of cardiac diseases 15.4% vs 7.9%, p<0.001. Adjusted ORs (95% CI) for hypertension, dyslipidemia, cardiac disease and diabetes among stroke subjects compared with controls were 6.43 (5.84-7.54), 2.08 (1.61-2.69), 1.48 (1.15-1.91) and 1.29 (1.05-1.60) respectively. Conclusion: Implementation of interventions towards mitigating the impact of vascular risk factors at the population level would be essential in curtailing the growing burden of stroke in Africans.

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