Metabolic risk factors for stroke and transient ischemic attacks in middle-aged men: a community-based study with long-term follow-up.

Abstract

BACKGROUND AND PURPOSE:

The impact of lipometabolic and glucometabolic disturbances on stroke incidence remains to be characterized in detail. We investigated relations of a comprehensive panel of baseline lipometabolic and glucometabolic variables to incident fatal and nonfatal stroke or transient ischemic attack (TIA), and stroke subtypes.

METHODS:

A community-based prospective study of 2313 middle-aged men invited to a health survey at age 50.

RESULTS:

During a follow-up of up to 32 years, 421 developed stroke or TIA. In Cox proportional hazards analyses adjusting for treatment with cardiovascular drugs at baseline, 1-standard deviation increases in body mass index, systolic and diastolic blood pressures, serum proinsulin, and lipoprotein(a) were associated with 11 to 35% increased risk for subsequent stroke/TIA. Electrocardiographic left ventricular hypertrophy and smoking were also associated with a higher risk for stroke/TIA. Essentially the same variables were related to brain infarction/TIA. Higher proportions of palmitic (16:0), palmitoleic (16:1), and oleic acid (18:1) in cholesterol esters were associated with an increased risk, whereas a higher proportion of linoleic acid (18:2 n-6) was protective against stroke/TIA. Further adjusting all models also for hypertension, diabetes, the metabolic syndrome, serum cholesterol, atrial fibrillation, cardiovascular disease, smoking, and physical activity, essentially the same pattern was observed.

CONCLUSIONS:

Indices of an unhealthy dietary fat intake and a high serum lipoprotein (a) level predicted fatal and nonfatal stroke/TIA independently of established risk factors in a community-based sample of middle-aged men followed for 32 years.

• Authors: Bernice Wiberg, Johan Sundström, Johan Arnlöv, Andreas Terént, Bengt Vessby, Björn Zethelius, Lars Lind
• Journal: Stroke (Stroke) Vol. 37 Issue 12 Pg. 2898-903 (Dec 2006) ISSN: 1524-4628 [Electronic] United States
• PMID: 17053177 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dietary Fats
• Lipoproteins

Topics

• Aged
• Aged, 80 and over
• Dietary Fats (adverse effects)
• Follow-Up Studies
• Humans
• Ischemic Attack, Transient (blood, epidemiology)
• Lipoproteins (blood)
• Male
• Middle Aged
• Prospective Studies
• Residence Characteristics
• Risk Factors
• Stroke (blood, epidemiology)
• Time Factors