Stroke, Vol 25, 51-59, Copyright © 1994 by American Heart Association
K Jamrozik, RJ Broadhurst, CS Anderson and EG Stewart-Wynne
BACKGROUND AND PURPOSE--We sought to examine risk factors for all strokes
and for ischemic stroke and primary intracerebral hemorrhage separately.
METHODS--This was a population-based case-control study. Each case subject
meeting World Health Organization criteria for stroke (n = 536) from a
population-based register of acute cerebrovascular events compiled in
Perth, Western Australia, in 1989 to 1990 was matched for age and sex with
up to five control subjects drawn from the same geographical area.
Objective confirmation of the type of stroke was available from computed
tomography, magnetic resonance imaging, or necropsy for 86% of the case
subjects. Data on medical history and lifestyle factors were collected from
case and control subjects by interview of the subject or a proxy informant.
RESULTS--Current smoking, consumption of meat more than four times weekly,
and a history of hypertension or intermittent claudication were each
associated with increased risk in multivariate models for all strokes and
for all first- ever strokes. Consumption of 1 to 20 g/d alcohol in the
preceding week was associated with a significant reduction in the risk of
all strokes, all ischemic strokes, and of primary intracerebral hemorrhage,
while eating fish more than two times per month appeared to protect against
first-ever stroke and against primary intracerebral hemorrhage. Diabetes
mellitus was associated with a significantly increased risk of ischemic
stroke but a decreased risk of hemorrhagic stroke. CONCLUSIONS- -Risk
factors for ischemic and hemorrhagic stroke are not exactly the same.
Changes in lifestyle relating to tobacco and diet might make important
contributions to further reductions in the incidence of stroke.
ARTICLES
The role of lifestyle factors in the etiology of stroke. A population- based case-control study in Perth, Western Australia
Department of Public Health, University of Western Australia, Perth.
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