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(Stroke. 2004;35:7.)
© 2004 American Heart Association, Inc.

Original Contributions

Risk Factors for First-Ever Stroke in Older People in the North East of England

A Population-Based Study

Helen Rodgers, FRCP; Jane Greenaway, MSc; Tina Davies, MRCP; Ruth Wood, MSc; Nicholas Steen, PhD Richard Thomson, MD

From the School of Population and Health Sciences (Epidemiology & Public Health) (H.R., J.G., T.D., R.W., N.S., R.T.) and School of Clinical Medical Sciences (H.R., T.D.), University of Newcastle upon Tyne, and Northumbria Healthcare NHS Trust (H.R., T.D.), North Shields, Tyne and Wear, UK.

Correspondence to Dr Helen Rodgers, Reader in Stroke Medicine, School of Population and Health Sciences (Epidemiology & Public Health), The Medical School, Newcastle upon Tyne, NE2 4HH, UK. E-mail helen.rodgers{at}newcastle.ac.uk

Background and Purpose— Although older people potentially have most to gain from prevention, they have been excluded from or underrepresented in many stroke incidence studies. We sought to determine the risk factors for stroke in older people.

Methods— A 5-year follow-up study of a population-based cohort of 4440 subjects aged >65 years in northern England. Subjects were recruited from 27 general practices between 1995 and 1997.

Results— A total of 329 out of 4351 subjects with follow-up data suffered a first-ever stroke. On multivariate analysis, risk factors for stroke in older people included atrial fibrillation (hazard ratio [HR], 2.03 [95%CI, 1.31 to 3.16]); previous transient ischemic attack (1.87 [95% CI, 1.27 to 2.76]); smoking (1.72 [95% CI ,1.28 to 2.32]); and cardiovascular disease (1.55 [95% CI, 1.19 to 2.03]). The HR per 10-mm Hg increase in systolic blood pressure was 1.15 (95% CI, 1.06 to 1.24). Age was associated with a HR of 1.74 (95% CI, 1.42 to 2.12) per 10-year increase.

Conclusions— "Classic risk factors" increase the risk of stroke in older people. Stroke is not an inevitable consequence of aging, so by identifying and modifying risk factors in older people there are opportunities to reduce the incidence and mortality of this devastating condition.

Key Words: elderly • epidemiology • risk factors • stroke

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