1. Risk Factor Characterization of Ischemic Stroke Subtypes among West Africans
- Author
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Esther Abunimye, Osahon J Asowata, Gebregziabher Mulugeta, Obiora Okeke, Adeyemo Adebolaji, Michael Ampofo, Adebayo Oladimeji, Olumayowa Ogunronbi, Henry Iheonye, Abiodun H Bello, Philip M Kolo, Arti Singh, Godwin Osaigbovo, Josephine Akpalu, Godwin Ogbole, Osimhiarherhuo Adeleye, Ganiyu Amusa, Oyedunni Arulogun, Ugochukwu U Onyeonoro, Luqman Ogunjimi, Balogun Olayemi, Olabamiji Ajose, Bimbo Fawale, Daniel T. Lackland, Philip Oluleke Ibinaiye, Albert Akpalu, Lukman Owolabi, Sheila Adamu, Dorcas Owusu, Samuel Anu Olowookere, Suleiman Y Isah, Olufemi A Odunlami, Olaleye Adeniji, Wisdom Oguike, Benedict Calys-Tagoe, Adeseye A Akintunde, Philip Adebayo, Taofeek Sanni, Joseph Yaria, Adekunle Fakunle, Donna K. Arnett, Ezinne Uvere, Kenneth Arinze Ohagwu, Ezinne Melikam, Carolyn Jenkins, Lambert Tetteh Appiah, Kelechukwu Uwanuruochi, Taiwo Olunuga, J.A. Ogunmodede, Olalekan I Oyinloye, Moyinoluwalogo M Tito-Ilori, Morenikeji A. Komolafe, Richard Efidi, Salaam Abdul, SA Abubakar, Lucius Chidiebere Imoh, Francis Agyekum, Vincent Shidali, Reginald Obiako, Ruth Laryea, Innocent Ijezie Chukwuonye, Cynthia O Akisanya, Eunice Olabinri, Samuel Diala, Kazeem Akinwande, Nathaniel Adusei, Fred Stephen Sarfo, Kolawole Wahab, Abiodun M. Adeoye, Vida Obese, Emmanuel O Sanya, Atinuke M Agunloye, Sule Ag, Onoja Akpa, Raelle Tagge, Y. B. Mensah, Obiabo Olugbo, Joyce Ikubor, Hamisu A Dambatta, Julius Adesina, Wasiu Adeniyi, Adedeji A Egberongbe, Mayowa O. Owolabi, Okechukwu S Ogah, Rufus Akinyemi, Bruce Ovbiagele, Hemant K. Tiwari, and Joshua Akinyemi
- Subjects
Male ,medicine.medical_specialty ,Nigeria ,Ghana ,Article ,Risk Factors ,Internal medicine ,medicine ,Diabetes Mellitus ,Humans ,Obesity ,Risk factor ,Aged ,Dyslipidemias ,Ischemic Stroke ,Advanced and Specialized Nursing ,business.industry ,Middle Aged ,medicine.disease ,West african ,Africa, Western ,Case-Control Studies ,Ischemic stroke ,Hypertension ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Dyslipidemia - Abstract
Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 427 (17.6%) large-artery atherosclerosis, 258 (10.6%) cardio-embolic, 3 (0.1%) carotid dissections, and 719 (29.6%) undetermined/other causes. The adjusted odds ratio (95% CI) for the 8 dominant risk factors for ischemic stroke were hypertension, 10.34 (6.91–15.45); dyslipidemia, 5.16 (3.78–7.03); diabetes, 3.44 (2.60–4.56); low green vegetable consumption, 1.89 (1.45–2.46); red meat consumption, 1.89 (1.45–2.46); cardiac disease, 1.88 (1.22–2.90); monthly income $100 or more, 1.72 (1.24–2.39); and psychosocial stress, 1.62 (1.18–2.21). Hypertension, dyslipidemia, diabetes were confluent factors shared by small-vessel, large-vessel and cardio-embolic subtypes. Stroke cases and stroke-free controls had a mean of 5.3±1.5 versus 3.2±1.0 adverse cardio-metabolic risk factors respectively ( P Conclusions: Traditional vascular risk factors demonstrate important differential effect sizes with pathophysiologic, clinical and preventative implications on the occurrence of ischemic stroke among indigenous West Africans.
- Published
- 2021