Stroke, Vol 25, 2370-2376, Copyright © 1994 by American Heart Association
RD Abbott, GR Behrens, DS Sharp, BL Rodriguez, CM Burchfiel, GW Ross, K Yano and JD Curb
BACKGROUND AND PURPOSE: While evidence suggests that obesity has an
independent relation to coronary artery disease, similar findings for
stroke have not been established. The purpose of this study was to examine
the relation between body mass index and the risk of thromboembolic stroke
independently of other risk factors. METHODS: Since 1965, the Honolulu
Heart Program has followed a cohort of men in a prospective study of
cardiovascular disease. This article examines the relationship between the
baseline measurement of body mass index and the risk of thromboembolic
stroke in 1163 nonsmoking men in older middle age (55 to 68 years). Men who
had an elevated risk of stroke due to hypertension, diabetes, and other
risk factors were excluded from the analysis. RESULTS: After 22 years of
follow-up, the rate of stroke increased significantly with increasing
levels of body mass (P < .01). In the bottom tertile of the body mass
index, the rate of thromboembolic stroke was 28.7 per 1000 (11/383). In the
middle tertile, the rate was increased by 40% to 40.7 per 1000 (16/393),
and in the top tertile, the rate of thromboembolic stroke was 55.4 per 1000
(21/387), a twofold excess compared with the bottom tertile. After
adjustment for age and the residual effects of confounding risk factors,
including systolic blood pressure and serum glucose, the estimated relative
risk of stroke for the average body mass index in the top tertile (26.6
kg/m2) compared with that in the bottom tertile (20.3 kg/m2) was 2.1 (95%
confidence interval, 1.1 to 4.1). These findings were not affected by
coronary events that occurred in the course of follow-up, nor did they
appear to be influenced by deaths from other causes. CONCLUSIONS: We
conclude that elevated body mass is associated with an increased risk of
thromboembolic stroke in nonsmoking men in older middle age who are free of
commonly observed conditions related to cardiovascular disease.
ARTICLES
Body mass index and thromboembolic stroke in nonsmoking men in older middle age. The Honolulu Heart Program
Division of Biostatistics, University of Virginia School of Medicine, Charlottesville 22908.
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