American Journal of Epidemiology Advance Access originally published online on March 22, 2006
American Journal of Epidemiology 2006 163(10):893-902; doi:10.1093/aje/kwj110
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original Contribution |
Favorable Cardiovascular Risk Profile (Low Risk) and 10-Year Stroke Incidence in Women and Men: Findings from 12 Italian Population Samples
1 National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
2 University of Naples "Federico II," Naples, Italy
3 Cardiovascular Prevention Unit, A.S.S. 4 "Medio Friuli," Udine, Italy
4 Department of Clinical and Biological Science, University of Insubria, Varese, Italy
5 Center of Chronic-Degenerative Disease, University of Milan-Biccocca, Monza, Italy
6 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
Reprint requests to Dr. Jeremiah Stamler, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Suite 1102, 680 North Lake Shore Drive, Chicago, IL 60611 (e-mail: j-stamler{at}northwestern.edu).
Recently, the focus of research on cardiovascular risk factors has broadened because of new data demonstrating benefits of low risk (i.e., favorable) levels of all major modifiable risk factors. Most data on low risk relate to coronary heart disease, not stroke. This population-based, 12-sample, Italian study (Progetto CUORE, 1983–2002), with 10-year follow-up, assessed the relation of low risk to stroke and implications for prevention. At baseline, women and men were 35–69 years of age. Only 3% were low risk; 80% were high risk. Overall, stroke incidence rates were 20.7 for men and 9.6 for women per 10,000 person-years. No strokes occurred in low risk participants, and stroke incidence was low with borderline elevation of only one risk factor. Four modifiable risk factors—elevated blood pressure, smoking, diabetes, and high total cholesterol/high density lipoprotein cholesterol ratio—related independently to stroke risk. For those at low risk or who had only one unfavorable (but not high) risk factor, the stroke rate was 76% lower than for high risk participants; for all persons not at high risk, the stroke rate was 57% lower than for those at high risk. Results show that favorable risk factor levels assure minimal stroke risk. Population-wide prevention is needed, especially improved lifestyles, to increase the prevalence of low risk.
cerebrovascular accident; incidence; longitudinal studies; primary prevention; risk; risk factors; risk reduction behavior
Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; MONICA, Monitoring of Trends and Determinants in Cardiovascular Disease; MRFIT, Multiple Risk Factor Intervention Trial; SBP, systolic blood pressure; U-NHRi, unfavorable but not high risk
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. S. Ford, C. Li, G. Zhao, W. S. Pearson, and S. Capewell Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States Adults Circulation, September 29, 2009; 120(13): 1181 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Asplund, J. Karvanen, S. Giampaoli, P. Jousilahti, M. Niemela, G. Broda, G. Cesana, J. Dallongeville, P. Ducimetriere, A. Evans, et al. Relative Risks for Stroke by Age, Sex, and Population Based on Follow-Up of 18 European Populations in the MORGAM Project Stroke, July 1, 2009; 40(7): 2319 - 2326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. Folsom, K. Yamagishi, A. Hozawa, L. E. Chambless, and for the Atherosclerosis Risk in Communities Study Absolute and Attributable Risks of Heart Failure Incidence in Relation to Optimal Risk Factors Circ Heart Fail, January 1, 2009; 2(1): 11 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Stamler Low Risk--and the "No More Than 50%" Myth/Dogma Arch Intern Med, March 26, 2007; 167(6): 537 - 539. [Full Text] [PDF]
|
|