In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
Abstract:
Background: American Stroke Association has listed hypertension, smoking, diabetes, high cholesterol, physical inactivity and atrial fibrillation as the major risk factors for stroke. We developed a new model to predict stroke mortality using the 15-year prospective data of half a million adults in Taiwan. The model identified additional important risk factors. Method: In a health surveillance program conducted from 1994 to 2008, a cohort of 541,047 adults were recruited. Among them, we identified 18,296 deaths, including 946 deaths from Ischemic stroke and 597 deaths from hemorrhagic stroke. We developed a prediction model for stroke mortality, with the area under ROC curve of 0.921 for all stroke, of 0.949 for ischemic stroke or of 0.936 for hemorrhagic stroke. As many as 14 variables or confounders were controlled by Cox model in calculating hazard ratios (HR). Results: In addition to hypertension, smoking, diabetes, inactivity and high cholesterol, this prediction model revealed that chronic kidney disease (CKD), either proteinuria or low GFR, low total cholesterol ( 〈 160 mg/dL) or HDL cholesterol ( 〈 35 mg/dL), rapid heart rate (≧90 beats/min), elevated C-Reactive Protein (CRP) ( 〉 3 mg/dL), Aspartate Aminotransferase (AST) (≧40 IU/L), and uric acid (≧7 mg/dL) were also important risk factors associated with stroke deaths. In contrast, physical activity reduced mortality from total stroke by 29%, from ischemic stroke by 32% and from hemorrhagic stroke by 22%. Conclusion: In addition to commonly known risk factors, we identified from this Chinese population at least 6 additional risk factors for stroke: (1) CKD, either proteinuria or low GFR, (2) low total or HDL cholesterol, (3) rapid heart rate, (4) elevated CRP, (5) elevated AST and (6) elevated uric acid. Being physically active is a powerful modifier, which could reduce stroke mortality by one third. Primary prevention of stroke should extend our consideration to controlling these additional risk factors and encourage regular exercise.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.49.suppl_1.TMP115
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
1467823-8
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