Risk Factors for Death From Stroke in Middle-aged Lithuanian Men

Author:

Rastenyte Daiva1,Tuomilehto Jaakko1,Domarkiene Stanislava1,Cepaitis Zygimantas1,Reklaitiene Regina1

Affiliation:

1. From the Kaunas Medical Academy, Institute of Cardiology, Lithuania (D.R., S.D., R.R.), and the National Public Health Institute, Department of Epidemiology and Health Promotion, Helsinki, Finland (J.T., Z.C.).

Abstract

Background and Purpose Although in eastern Europe, mortality from stroke at present is the highest in the world, no previous prospective study of the risk factors for stroke has been reported from this part of the world. The aim of our study, therefore, was to evaluate the relations between blood pressure, serum total cholesterol, glucose intolerance, body mass index, and cigarette smoking and the risk of death from stroke in middle-aged men in Kaunas, Lithuania. Methods We conducted a prospective study with an average follow-up of 17.5 years of 2295 men who had participated in risk factor surveys within the framework of the World Health Organization Kaunas-Rotterdam Intervention Study from 1972 to 1974. Risk factors included in the current analyses were smoking, blood pressure, serum total cholesterol, glucose intolerance, diabetes, and body mass index. Age- and risk factor–adjusted relative risks (RR) for death of stroke were determined by use of the Cox proportional hazards model. Results The strongest risk factors for death from stroke in middle-aged men were systolic blood pressure (RR=1.02; P =.0001), diabetes (RR=4.17; P =.02), and smoking (RR=2.01; P =.004). Serum cholesterol, impaired glucose tolerance, and body mass index were not related to the risk of death from stroke. Twenty-five percent and 19% of stroke deaths were attributed to hypertension and smoking, respectively. Conclusions Prevention and effective control of hypertension, smoking, and diabetes are the key elements in primary prevention of stroke in eastern Europe, where stroke mortality remains high.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

Reference38 articles.

1. Stroke mortality trends an international perspective

2. Miseviciene I. Epidemiology of Main Noncommunicable Diseases and Some Issues of Methodology of Primary Prevention in Lithuania [in Russian]. Kaunas Lithuania: Kaunas Medical Institute; 1990. Dissertation.

3. Trends in the Incidence and Mortality of Stroke in Kaunas, Lithuania, 1986-1993

4. Stroke around the Baltic Sea: Incidence, Case Fatality and Population Risk Factors in Denmark, Finland, Sweden and Lithuania

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