M Gliksman1, A Wilson. 1. Department of Community Medicine, University of Sydney, Australia.
Abstract
BACKGROUND: The paradoxical occurrence of a high risk of stroke in some populations at low risk for coronary heart disease has long been known. Recently, evidence has appeared linking the paradoxical risk to population-based differences in diet, serum cholesterol, and alcohol intake. However, the pathophysiological mechanism of action that would explain this paradox is unlikely to be atherosclerosis alone. SUMMARY OF COMMENT: Several recent cross-sectional and prospective population studies have shown that hemostatic factors vary between populations in a manner consistent with the paradox. Studies have also shown that certain hemostatic factors are independent predictors of risk of coronary heart disease, ischemic stroke, and, probably, hemorrhagic stroke. CONCLUSIONS: Risk factors that enhance thrombosis and reduce fibrinolysis are capable of explaining the paradoxical occurrence of the incidence of coronary heart disease and stroke in certain populations.
BACKGROUND: The paradoxical occurrence of a high risk of stroke in some populations at low risk for coronary heart disease has long been known. Recently, evidence has appeared linking the paradoxical risk to population-based differences in diet, serum cholesterol, and alcohol intake. However, the pathophysiological mechanism of action that would explain this paradox is unlikely to be atherosclerosis alone. SUMMARY OF COMMENT: Several recent cross-sectional and prospective population studies have shown that hemostatic factors vary between populations in a manner consistent with the paradox. Studies have also shown that certain hemostatic factors are independent predictors of risk of coronary heart disease, ischemic stroke, and, probably, hemorrhagic stroke. CONCLUSIONS: Risk factors that enhance thrombosis and reduce fibrinolysis are capable of explaining the paradoxical occurrence of the incidence of coronary heart disease and stroke in certain populations.
Authors: Neil A Zakai; Leslie A McClure; Suzanne E Judd; Brett Kissela; George Howard; Monika Safford; Mary Cushman Journal: Thromb Haemost Date: 2016-12-22 Impact factor: 5.249