Meta-analysis of Early Risk Factors Associated with Cerebrovascular Diseases

Introduction: Cerebrovascular diseases primarily affect the blood vessels in the brain and often result in life-threatening complications such as stroke. Several modifiable and non-modifiable risk factors contribute significantly to disease onset and progression. Owing to the complex interplay between the risk factors of cerebrovascular diseases, statistically proven inferences regarding the involvement of various risk factors in cerebrovascular disease are highly warranted. Methods: A systematic search was conducted to identify relevant literature concerning early-life risk factors for cerebrovascular diseases, which were explicitly defined as cerebrovascular events such as stroke and transient ischemic attacks (TIA). Studies were selected from PubMed, Medline, and Google Scholar databases. The search strategy was structured around five key conceptual areas to manage redundancy and included terms related to the life phase of "early childhood to late adolescence" to serve as the necessary age-specific criteria for exposures. The comprehensive data search was completed on October 10, 2023. Two independent reviewers screened articles based on PRISMA guidelines, and while a broad range of designs were included (cohort, observational, etc.), we defined the "early-life" exposure period strictly. The methodological quality and risk of bias for each study were assessed using a custom, criteria-based quality assessment framework, informed by established systematic review methodology. This assessment evaluated six specific domains of bias (including sample representativeness, attrition rates, and adjustment for confounders), with each domain rated on a scale of 1 (highest risk of bias) to 4 (lowest risk of bias). Results: The analysis identified strong associations between male gender, high blood pressure, smoking, elevated cholesterol, high BMI, hypertension, diabetes, adverse childhood experiences, and cerebrovascular disease. However, other factors such as low physical activity, low birth weight, and low IQ were not conclusively linked to the disease based on the available literature. Discussion: This meta-analysis confirmed that factors such as male gender, high blood pressure, BMI, smoking, hypertension, diabetes, and socioeconomic status significantly increase the risk of cerebrovascular diseases, while cholesterol and adverse childhood experiences show a suggestive increase in the risk of cerebrovascular diseases. Conclusion: Conclusively, the present report shows that early-life and modifiable factors, including but not limited to high BMI, hypertension, and diabetes, significantly increase the chances of developing cerebrovascular diseases. Furthermore, the reported evidence also indicated that factors such as low physical activity, low IQ, and low birth weight remain inconclusive as risk factors for cerebrovascular diseases. These evidences strengthen the need and importance of preventive, targeted strategies beginning early in life to reduce the burden of long-term cerebrovascular diseases.