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Determinants of Stroke in a General Male Population: Forty-Eight Year Time-Dependent Updated Follow-Up of the Study of Men Born in 1913
Univ Gothenburg, Sahlgrenska Acad, Dept Clin Neurosci, Rehabil Med,Inst Neurosci & Physiol, SE-41345 Gothenburg, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.ORCID iD: 0000-0002-8925-9670
Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.
Univ Gothenburg, Sahlgrenska Acad, Dept Clin Neurosci, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Stroke Ctr West, Inst Neurosci & Physiol, Gothenburg, Sweden.
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2018 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 49, no 12, p. 2830-2836Article in journal (Refereed) Published
Abstract [en]

Background and Purpose - To further improve preventive strategies against stroke, there is a need for epidemiological long-term studies. The study aimed at a prospective investigation of stroke determinants in the general male population.

Methods - During a period of 48 years, from 50 to 98 years of age, a population-based sample of 854 men was followed using repeated medical examinations, lifestyle questionnaires, data from hospital records and the National Cause of Death Register.

Results - Determinants of ischemic stroke were atrial fibrillation (hazard ratio [HR], 6.61; 95% CI, 4.47-9.77); mother dead from cardiovascular disease (HR, 1.53; 1.09-2.17); high education (HR, 0.81; 0.69-0.96); and high physical activity level during leisure time (HR, 0.68; 0.50-0.93). For hemorrhagic stroke heart rate (HR, 1.04; 1.01-1.06) and mother dead from stroke (HR, 3.56; 1.43-8.87) constituted an increased risk. Statistically significant determinants for all stroke were atrial fibrillation (HR, 5.34; 3.68-7.75); high diastolic blood pressure (HR, 1.02; 1.01-1.03); high body weight (HR, 0.96; 0.94-0.99); high educational level (HR, 0.79; 0.68-0.92); wide waist circumference (HR, 1.04; 1.01-1.07); smoking (HR, 1.25; 1.06-1.48); mother dead from cerebrovascular disease (HR, 1.43; 1.05-1.94); and diabetes mellitus (HR, 1.65; 1.02-2.68). Of all men diagnosed with atrial fibrillation, 88% had a stroke during follow-up.

Conclusions - Atrial fibrillation was by far the strongest determinant of stroke during 48 years of follow-up in a male population sample followed until the age of 98 years. The results warrant improved prophylaxis through intense treatment of modifiable determinants.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2018. Vol. 49, no 12, p. 2830-2836
Keywords [en]
atrial fibrillation, cardiovascular diseases, epidemiology, risk factors, stroke
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-376899DOI: 10.1161/STROKEAHA.118.022740ISI: 000456427700018PubMedID: 30571393OAI: oai:DiVA.org:uu-376899DiVA, id: diva2:1287808
Funder
Swedish Heart Lung FoundationAvailable from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-02-12Bibliographically approved

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