Literature DB >> 19520994

Relative risks for stroke by age, sex, and population based on follow-up of 18 European populations in the MORGAM Project.

Kjell Asplund1, Juha Karvanen, Simona Giampaoli, Pekka Jousilahti, Matti Niemelä, Grazyna Broda, Giancarlo Cesana, Jean Dallongeville, Pierre Ducimetriere, Alun Evans, Jean Ferrières, Bernadette Haas, Torben Jorgensen, Abdonas Tamosiunas, Diego Vanuzzo, Per-Gunnar Wiklund, John Yarnell, Kari Kuulasmaa, Sangita Kulathinal.   

Abstract

BACKGROUND AND
PURPOSE: Within the framework of the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project, the variations in impact of classical risk factors of stroke by population, sex, and age were analyzed.
METHODS: Follow-up data were collected in 43 cohorts in 18 populations in 8 European countries surveyed for cardiovascular risk factors. In 93 695 persons aged 19 to 77 years and free of major cardiovascular disease at baseline, total observation years were 1 234 252 and the number of stroke events analyzed was 3142. Hazard ratios were calculated by Cox regression analyses.
RESULTS: Each year of age increased the risk of stroke (fatal and nonfatal together) by 9% (95% CI, 9% to 10%) in men and by 10% (9% to 10%) in women. A 10-mm Hg increase in systolic blood pressure involved a similar increase in risk in men (28%; 24% to 32%) and women (25%; 20% to 29%). Smoking conferred a similar excess risk in women (104%; 78% to 133%) and in men (82%; 66% to 100%). The effect of increasing body mass index was very modest. Higher high-density lipoprotein cholesterol levels decreased the risk of stroke more in women (hazard ratio per mmol/L 0.58; 0.49 to 0.68) than in men (0.80; 0.69 to 0.92). The impact of the individual risk factors differed somewhat between countries/regions with high blood pressure being particularly important in central Europe (Poland and Lithuania).
CONCLUSIONS: Age, sex, and region-specific estimates of relative risks for stroke conferred by classical risk factors in various regions of Europe are provided. From a public health perspective, an important lesson is that smoking confers a high risk for stroke across Europe.

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Year:  2009        PMID: 19520994     DOI: 10.1161/STROKEAHA.109.547869

Source DB:  PubMed          Journal:  Stroke        ISSN: 0039-2499            Impact factor:   7.914


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