Key result
Significant risk factors for first ischemic stroke included definite hypertension (RR 4.0), transient ischemic attacks (RR 3.9), and coronary heart disease (RR 2.2); atrial fibrillation was not.
Why the study?
What are the independent risk factors for incident ischemic stroke in adults aged 50 and older?
Cohort (n=1,804)
No
What are the independent risk factors for incident ischemic stroke in adults aged 50 and older?
Hypertension and transient ischemic attacks are the strongest independent risk factors for first ischemic stroke in older adults, whereas atrial fibrillation was not a significant independent predictor in this time-dependent analysis.
Answers are grounded in this paper and cite their sources.
Hypertension and TIA associate with first ischemic stroke in older adults; leaves open AF's independent role in time-dependent models.
A cohort of 1,804 residents of Rochester, Minnesota, who were at least 50 years old, free of stroke, and who underwent examination at the Mayo Clinic in 1960, was followed for 13 years. During this period, there were 110 first ischemic strokes and 616 deaths without stroke. The time of onset, if available, or the time of diagnosis of potential risk factors was determined for all patients during the study and was used to construct a proportional hazards model of time to occurrence of stroke with time-dependent risk factors. The model included 8 risk factors (2 fixed and 6 time-dependent). For these, the individual relative risks are: 1.6 for age (per 10 years), 2.0 for males, 4.0 for definite hypertension, 3.9 for transient ischemic attacks, 2.2 for hypertensive heart disease, 2.2 for coronary heart disease, 1.7 for congestive heart failure, and 1.7 for diabetes mellitus. Atrial fibrillation was not a significant risk factor using time-dependent multivariate analysis.
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Davis et al. (1987) conducted a cohort in Ischemic stroke (n=1,804). Risk factors was evaluated on First ischemic stroke (RR 4.0 (hypertension), RR 3.9 (TIA)). Significant risk factors for first ischemic stroke included definite hypertension (RR 4.0), transient ischemic attacks (RR 3.9), and coronary heart disease (RR 2.2); atrial fibrillation was not.
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