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Stroke Risk Factors, Genetics, and Prevention

Published on Feb 3, 2017in Circulation Research 15.86
· DOI :10.1161/CIRCRESAHA.116.308398
Amelia K Boehme8
Estimated H-index: 8
(Columbia University),
Charles C. Esenwa4
Estimated H-index: 4
(Columbia University),
Mitchell S.V. Elkind63
Estimated H-index: 63
(Columbia University)
Cite
Abstract
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention.
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  • References (289)
  • Citations (51)
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References289
Newest
Published on Sep 1, 2016in Journal of Hypertension 4.25
Peter M. Okin57
Estimated H-index: 57
,
Hooman Kamel33
Estimated H-index: 33
+ 1 AuthorsRichard B. Devereux128
Estimated H-index: 128
Recent findings in population-based studies suggest that abnormal P wave terminal force in lead V1 (PTFV1), a marker of left atrial abnormalities such as fibrosis, dilatation and elevated filling pressures, is associated with incident ischemic stroke, even in the absence of atrial fibrillation. However, whether PTFV1 predicts incident stroke in hypertensive patients during blood pressure lowering has not been examined.Risk of incident stroke was examined in relation to abnormal PTFV1 on a baseli...
Published on Aug 9, 2016in BMJ 27.60
Hmwe H Kyu28
Estimated H-index: 28
(UW: University of Washington),
Victoria F Bachman4
Estimated H-index: 4
(UW: University of Washington)
+ 11 AuthorsMadeline L. Moyer7
Estimated H-index: 7
(UW: University of Washington)
Objective To quantify the dose-response associations between total physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events. Design Systematic review and Bayesian dose-response meta-analysis. Data sources PubMed and Embase from 1980 to 27 February 2016, and references from relevant systematic reviews. Data from the Study on Global AGEing and Adult Health conducted in China, Ghana, India, Mexico, Russia, and South Africa from 2007 to ...
Published on Jul 1, 2016in Stroke 6.05
George Howard82
Estimated H-index: 82
(UAB: University of Alabama at Birmingham),
Claudia S. Moy47
Estimated H-index: 47
(NIH: National Institutes of Health)
+ 10 AuthorsMonika M. Safford52
Estimated H-index: 52
(Cornell University)
Background and Purpose—At age 45 years, blacks have a stroke mortality ≈3× greater than their white counterparts, with a declining disparity at older ages. We assess whether this black–white disparity in stroke mortality is attributable to a black–white disparity in stroke incidence versus a disparity in case fatality. Methods—We first assess if black–white differences in stroke mortality within 29 681 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort r...
Published on Jun 21, 2016in Annals of Internal Medicine 19.32
Janelle Guirguis-Blake10
Estimated H-index: 10
(UW: University of Washington),
Corinne V Evans7
Estimated H-index: 7
(UW: University of Washington)
+ 2 AuthorsEvelyn P. Whitlock48
Estimated H-index: 48
(UW: University of Washington)
Published on Jun 9, 2016in The New England Journal of Medicine 70.67
Jackson T. Wright57
Estimated H-index: 57
(Case Western Reserve University),
Jeff D. Williamson56
Estimated H-index: 56
(Wake Forest University)
+ 15 AuthorsCora E. Lewis85
Estimated H-index: 85
(UAB: University of Alabama at Birmingham)
The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain.We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, oth...
Published on Jun 1, 2016in Lancet Neurology 28.75
Ganesh Chauhan20
Estimated H-index: 20
,
Corey R. Arnold3
Estimated H-index: 3
+ 134 AuthorsHieab H.H. Adams18
Estimated H-index: 18
Summary Background Genetic determinants of stroke, the leading neurological cause of death and disability, are poorly understood and have seldom been explored in the general population. Our aim was to identify additional loci for stroke by doing a meta-analysis of genome-wide association studies. Methods For the discovery sample, we did a genome-wide analysis of common genetic variants associated with incident stroke risk in 18 population-based cohorts comprising 84 961 participants, of whom 434...
Published on May 26, 2016in The New England Journal of Medicine 70.67
William C. Cushman56
Estimated H-index: 56
,
David C. Goff75
Estimated H-index: 75
(Colorado School of Public Health)
In view of the worldwide burden of cardiovascular disease and the high cost of and poor adherence to medication regimens for the prevention of cardiovascular disease, the concept of a “polypill” — a single pill that combines several medications — is an attractive public health approach. However, evidence that each component of a polypill would independently reduce the risk of cardiovascular events and that the combination of agents would be safe is lacking. The primary results of the Heart Outco...
Published on May 26, 2016in The New England Journal of Medicine 70.67
Salim Yusuf Mb Bs DPhil Frcpc209
Estimated H-index: 209
(McMaster University),
Jackie Bosch43
Estimated H-index: 43
(McMaster University)
+ 30 AuthorsAntonio L. Dans17
Estimated H-index: 17
(UPM: University of the Philippines Manila)
BackgroundPrevious trials have shown that the use of statins to lower cholesterol reduces the risk of cardiovascular events among persons without cardiovascular disease. Those trials have involved persons with elevated lipid levels or inflammatory markers and involved mainly white persons. It is unclear whether the benefits of statins can be extended to an intermediate-risk, ethnically diverse population without cardiovascular disease. MethodsIn one comparison from a 2-by-2 factorial trial, we r...
Published on May 26, 2016in The New England Journal of Medicine 70.67
Eva Lonn64
Estimated H-index: 64
(McMaster University),
Jackie Bosch43
Estimated H-index: 43
(McMaster University)
+ 30 AuthorsAntonio L. Dans17
Estimated H-index: 17
(UPM: University of the Philippines Manila)
BackgroundAntihypertensive therapy reduces the risk of cardiovascular events among high-risk persons and among those with a systolic blood pressure of 160 mm Hg or higher, but its role in persons at intermediate risk and with lower blood pressure is unclear. MethodsIn one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to receive either candesartan at a dose of 16 mg per day plus hydrochlorothiazide a...
Published on May 26, 2016in The New England Journal of Medicine 70.67
Salim Yusuf Mb Bs DPhil Frcpc209
Estimated H-index: 209
(McMaster University),
Eva Lonn64
Estimated H-index: 64
(McMaster University)
+ 29 AuthorsLeopoldo Soares Piegas24
Estimated H-index: 24
BACKGROUND Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially.METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In th...
Cited By51
Newest
Published on Feb 13, 2019in Journal of Translational Medicine 4.10
Rongjun Zou3
Estimated H-index: 3
(SYSU: Sun Yat-sen University),
Dingwen Zhang1
Estimated H-index: 1
(SYSU: Sun Yat-sen University)
+ 7 AuthorsPing Hua3
Estimated H-index: 3
(SYSU: Sun Yat-sen University)
Background Atrial fibrillation (AF) is one of the most prevalent sustained arrhythmias, however, epidemiological data may understate its actual prevalence. Meanwhile, AF is considered to be a major cause of ischemic strokes due to irregular heart-rhythm, coexisting chronic vascular inflammation, and renal insufficiency, and blood stasis. We studied co-expressed genes to understand relationships between atrial fibrillation (AF) and stroke and reveal potential biomarkers and therapeutic targets of...
Published in BMC Neurology 2.23
Ginenus Fekadu (Wollega University), Legese Chelkeba1
Estimated H-index: 1
(JU: Jimma University),
Ayantu Kebede (JU: Jimma University)
Stroke is the second-leading global cause of death behind heart disease in 2013 and is a major cause of permanent disability. The burden of stroke in terms of mortality, morbidity and disability is increasing across the world. It is currently observed to be one of the commonest reasons of admission in many health care setups and becoming an alarming serious public health problem in our country Ethiopia. Despite the high burden of strokes globally, there is insufficient information on the current...
Published in Stroke 6.05
Daniel Puhr-Westerheide5
Estimated H-index: 5
(LMU: Ludwig Maximilian University of Munich),
Steffen Tiedt7
Estimated H-index: 7
(LMU: Ludwig Maximilian University of Munich)
+ -3 AuthorsKolja M. Thierfelder15
Estimated H-index: 15
Background and Purpose— Large vessel occlusion stroke leads to highly variable hyperacute infarction growth. Our aim was to identify clinical and imaging parameters associated with hyperacute infar...
Maria Shvedova2
Estimated H-index: 2
(Harvard University),
Maxim M. Litvak1
Estimated H-index: 1
(Tomsk Polytechnic University)
+ -3 AuthorsHyung-Hwan Kim22
Estimated H-index: 22
(Harvard University)
Recent works highlight the therapeutic potential of targeting cyclic guanosine monophosphate (cGMP)-dependent pathways in the context of brain ischemia/reperfusion injury (IRI). Although cGMP-depen...
Published on May 15, 2019in Acta Neurologica Scandinavica 2.85
Yang Si (CAS: Chinese Academy of Sciences), Xiaoqiang Xiao (CAS: Chinese Academy of Sciences)+ 5 AuthorsHongbin Sun (CAS: Chinese Academy of Sciences)
Published on Jun 1, 2019in Pharmacological Research 5.57
Tom Leech , Nipon Chattipakorn32
Estimated H-index: 32
(CMU: Chiang Mai University),
Siriporn C. Chattipakorn26
Estimated H-index: 26
(CMU: Chiang Mai University)
Abstract Cerebral ischaemia/reperfusion (I/R) injury is the transient loss, followed by rapid return, of blood flow to the brain. This condition is often caused by strokes and heart attacks. The underlying mechanisms resulting in brain damage during cerebral I/R injury include mitochondrial dysregulation, increased oxidative stress/reactive oxygen species, blood-brain-barrier breakdown, inflammation of the brain, and increased neuronal apoptosis. Metformin is the first-line antidiabetic drug whi...
Published on Apr 12, 2019in Journal of Thrombosis and Thrombolysis 2.94
Jing Song5
Estimated H-index: 5
(PKU: Peking University),
Yiqun Wu5
Estimated H-index: 5
(PKU: Peking University)
+ 3 AuthorsYonghua Hu13
Estimated H-index: 13
(PKU: Peking University)
The rs7903146, an established genetic variant susceptible to type 2 diabetes (T2D), is also reported to be related to ischemic stroke (IS), though conflicting. Furthermore, it remained unknown whether the genetic association with stroke is independent of T2D. In the current study, 1603 individuals across 986 families were included. The genetic pleiotropic effect on each outcome diseases (T2D, overall IS, or each subtype) was assessed using multilevel logistic regression after adjustment for mult...
Published on May 14, 2019in Journal of Health Research
Patcharaporn Aree , Tanyarat Jomgeow1
Estimated H-index: 1
(CMU: Chiang Mai University)
+ 1 AuthorsChiraporn Tachaudomdach (CMU: Chiang Mai University)
The purpose of this paper is to study serum lipids, lipoproteins, homocysteine (Hcy) and platelet-derived growth factor (PDGF), and to evaluate the relationship between serum lipids, lipoproteins, Hcy and PDGF in patients with hypertension.,In total, 85 patients with hypertension (34 males, 51 females) were recruited from October to December 2015 at Saraphi Hospital, Chiang Mai Province using purposive sampling. PDGF mRNA levels of the patients were analyzed using the RT-PCR method. Hcy was anal...
Published on Oct 1, 2018in Neurochemistry International 3.99
Xuefang Ren12
Estimated H-index: 12
,
Elizabeth B. Engler-Chiurazzi6
Estimated H-index: 6
+ 6 AuthorsJames W. Simpkins67
Estimated H-index: 67
(WVU: West Virginia University)
Abstract Aging of the nervous system, and the occurrence of age-related brain diseases such as stroke, are associated with changes to a variety of cellular processes controlled by many distinct genes. MicroRNAs (miRNAs), short non-coding functional RNAs that can induce translational repression or site-specific cleavage of numerous target mRNAs, have recently emerged as important regulators of cellular senescence, aging, and the response to neurological insult. Here, we focused on the assessment ...