Stroke, Vol 22, 203-208, Copyright © 1991 by American Heart Association
J Woo, E Lau, CW Lam, R Kay, R Teoh, HY Wong, WY Prall, L Kreel and MG Nicholls
We analyzed the serum concentrations of lipids and lipoproteins and the
prevalence of other risk factors in a case-control study of 304 consecutive
Chinese patients with acute stroke (classified as cerebral infarction,
lacunar infarction, or intracerebral hemorrhage) and 304 age- and
sex-matched controls. For all strokes we identified the following risk
factors: a history of ischemic heart disease, diabetes mellitus, or
hypertension; the presence of atrial fibrillation or left ventricular
hypertrophy; a glycosylated hemoglobin A1 concentration of greater than
9.1%; a fasting plasma glucose concentration 3 months after stroke of
greater than 6.0 mmol/l; a serum triglyceride concentration 3 months after
stroke of greater than 2.1 mmol/l; and a serum lipoprotein(a) concentration
of greater than 29.2 mg/dl. We found the following protective factors: a
serum high density lipoprotein- cholesterol concentration of greater than
1.59 mmol/l and a serum apolipoprotein A-I concentration of greater than or
equal to 106 mg/dl. The patterns of risk factors differed among the three
stroke subtypes. When significant risk factors were entered into a multiple
logistic regression model, we found a history of hypertension, a high serum
lipoprotein(a) concentration, and a low apolipoprotein A-I concentration to
be independent risk factors for all strokes. The attributable risk for
hypertension was estimated to be 24% in patients aged greater than or equal
to 60 years. In this population, in which cerebrovascular diseases are the
third commonest cause of mortality, identification of risk factors will
allow further studies in risk factor modification for the prevention of
stroke.
ARTICLES
Hypertension, lipoprotein(a), and apolipoprotein A-I as risk factors for stroke in the Chinese
Department of Medicine, Chinese University of Hong Kong.
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