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Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study.

Abstract

BACKGROUND AND PURPOSE

Obesity is well recognized as a risk factor for coronary heart disease and mortality. The relationship between abdominal obesity and ischemic stroke remains less clear. Our aim was to evaluate abdominal obesity as an independent risk factor for ischemic stroke in a multiethnic community.

METHODS

A population-based, incident case-control study was conducted July 1993 through June 1997 in northern Manhattan, New York, NY. Cases (n=576) of first ischemic stroke (66% >or=BORDER="0">65 years of age; 56% women; 17% whites; 26% blacks; 55% Hispanics) were enrolled and matched by age, sex, and race-ethnicity to stroke-free community controls (n=1142). All subjects were interviewed and examined and had measurements of waist-to-hip ratio (WHR). Odds ratios (ORs) of ischemic stroke were calculated with gender-specific quartiles (GQs) and gender-specific medians of WHR adjusted for stroke risk factors and body mass index (BMI).

RESULTS

Compared with the first quartile, the third and fourth quartiles of WHR had an increased risk of stroke (GQ3: OR, 2.4; 95% CI, 1.5 to 3.9; GQ4: OR, 3.0; 95% CI, 1.8 to 4.8) adjusted for other risk factors and BMI. Those with WHR equal to or greater than the median had an overall OR of 3.0 (95% CI, 2.1 to 4.2) for ischemic stroke even after adjustment for other risk factors and BMI. Increased WHR was associated with a greater risk of stroke in men and women and in all race-ethnic groups. The effect of WHR was stronger among younger persons (test for heterogeneity, P<0.0002) (<65 years of age: OR, 4.4; 95%CI, 2.2 to 9.0; >or=65 years of age: OR, 2.2; 95% CI, 1.4 to 3.2). WHR was associated with an increased risk among those with and without large-artery atherosclerotic stroke.

CONCLUSIONS

Abdominal obesity is an independent, potent risk factor for ischemic stroke in all race-ethnic groups. It is a stronger risk factor than BMI and has a greater effect among younger persons. Prevention of obesity and weight reduction need greater emphasis in stroke prevention programs.

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  • Authors+Show Affiliations

    ,

    Department of Neurology, Columbia University College of Physicians and Surgeons and the Mailman School of Public Health, New York, NY, USA.

    , , , , , ,

    Source

    Stroke 34:7 2003 Jul pg 1586-92

    MeSH

    Abdomen
    African Continental Ancestry Group
    Age Distribution
    Aged
    Body Constitution
    Body Mass Index
    Brain Ischemia
    Case-Control Studies
    Comorbidity
    Demography
    European Continental Ancestry Group
    Female
    Hispanic Americans
    Humans
    Incidence
    Male
    New York City
    Obesity
    Odds Ratio
    Risk Factors
    Sex Distribution
    Stroke

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12775882

    Citation

    Suk, Seung-Han, et al. "Abdominal Obesity and Risk of Ischemic Stroke: the Northern Manhattan Stroke Study." Stroke, vol. 34, no. 7, 2003, pp. 1586-92.
    Suk SH, Sacco RL, Boden-Albala B, et al. Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. Stroke. 2003;34(7):1586-92.
    Suk, S. H., Sacco, R. L., Boden-Albala, B., Cheun, J. F., Pittman, J. G., Elkind, M. S., & Paik, M. C. (2003). Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. Stroke, 34(7), pp. 1586-92.
    Suk SH, et al. Abdominal Obesity and Risk of Ischemic Stroke: the Northern Manhattan Stroke Study. Stroke. 2003;34(7):1586-92. PubMed PMID: 12775882.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. AU - Suk,Seung-Han, AU - Sacco,Ralph L, AU - Boden-Albala,Bernadette, AU - Cheun,Jian F, AU - Pittman,John G, AU - Elkind,Mitchell S, AU - Paik,Myunghee C, AU - ,, Y1 - 2003/05/29/ PY - 2003/5/31/pubmed PY - 2003/8/2/medline PY - 2003/5/31/entrez SP - 1586 EP - 92 JF - Stroke JO - Stroke VL - 34 IS - 7 N2 - BACKGROUND AND PURPOSE: Obesity is well recognized as a risk factor for coronary heart disease and mortality. The relationship between abdominal obesity and ischemic stroke remains less clear. Our aim was to evaluate abdominal obesity as an independent risk factor for ischemic stroke in a multiethnic community. METHODS: A population-based, incident case-control study was conducted July 1993 through June 1997 in northern Manhattan, New York, NY. Cases (n=576) of first ischemic stroke (66% >or=BORDER="0">65 years of age; 56% women; 17% whites; 26% blacks; 55% Hispanics) were enrolled and matched by age, sex, and race-ethnicity to stroke-free community controls (n=1142). All subjects were interviewed and examined and had measurements of waist-to-hip ratio (WHR). Odds ratios (ORs) of ischemic stroke were calculated with gender-specific quartiles (GQs) and gender-specific medians of WHR adjusted for stroke risk factors and body mass index (BMI). RESULTS: Compared with the first quartile, the third and fourth quartiles of WHR had an increased risk of stroke (GQ3: OR, 2.4; 95% CI, 1.5 to 3.9; GQ4: OR, 3.0; 95% CI, 1.8 to 4.8) adjusted for other risk factors and BMI. Those with WHR equal to or greater than the median had an overall OR of 3.0 (95% CI, 2.1 to 4.2) for ischemic stroke even after adjustment for other risk factors and BMI. Increased WHR was associated with a greater risk of stroke in men and women and in all race-ethnic groups. The effect of WHR was stronger among younger persons (test for heterogeneity, P<0.0002) (<65 years of age: OR, 4.4; 95%CI, 2.2 to 9.0; >or=65 years of age: OR, 2.2; 95% CI, 1.4 to 3.2). WHR was associated with an increased risk among those with and without large-artery atherosclerotic stroke. CONCLUSIONS: Abdominal obesity is an independent, potent risk factor for ischemic stroke in all race-ethnic groups. It is a stronger risk factor than BMI and has a greater effect among younger persons. Prevention of obesity and weight reduction need greater emphasis in stroke prevention programs. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/12775882/full_citation L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000075294.98582.2F?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -