Skip to main content
PMC home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1985 Aug;143(2):186–192.

Risk Factors in Stroke

Piero Mustacchi 1
PMCID: PMC1306269  PMID: 3898597

Abstract

In the United States, stroke accounts for 160,000 annual deaths; only 16% of the 1.8 million stroke survivors are fully independent. The incidence of stroke increases with age. Hemorrhagic strokes outnumber ischemic strokes before age 15. Japanese men in this country have a lower stroke mortality than their age peers in Japan. Excessive stroke mortality for US nonwhites may not be entirely due to the greater prevalence of hypertension among blacks. Hypertension emerges as the single most powerful and reversible risk factor in stroke and for survival after stroke. Impaired cardiac function is the second most important precursor of stroke. The recurrence of stroke in survivors is high. The frequency of completed stroke is high in persons with transient ischemic attacks, but not in those with asymptomatic carotid bruits. Other reversible risk factors are smoking, the use of oral contraceptives, alcoholic excess, a low level of physical activity, blood hyperviscosity and drug abuse.

Full text

PDF
186

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdon N. J., Zettervall O., Carlson J., Berglund S., Sterner G., Tejler L., Turesson I. Is occult atrial disorder a frequent cause of non-hemorrhagic stroke? Long-term ECG in 86 patients. Stroke. 1982 Nov-Dec;13(6):832–837. doi: 10.1161/01.str.13.6.832. [DOI] [PubMed] [Google Scholar]
  2. Ashley M. J. Alcohol consumption, ischemic heart disease and cerebrovascular disease. An epidemiological perspective. J Stud Alcohol. 1982 Sep;43(9):869–887. doi: 10.15288/jsa.1982.43.869. [DOI] [PubMed] [Google Scholar]
  3. Astrup J., Symon L., Branston N. M., Lassen N. A. Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke. 1977 Jan-Feb;8(1):51–57. doi: 10.1161/01.str.8.1.51. [DOI] [PubMed] [Google Scholar]
  4. BRICE J. G., DOWSETT D. J., LOWE R. D. THE EFFECT OF CONSTRICTION ON CAROTID BLOOD-FLOW AND PRESSURE GRADIENT. Lancet. 1964 Jan 11;1(7324):84–85. doi: 10.1016/s0140-6736(64)91397-2. [DOI] [PubMed] [Google Scholar]
  5. BROWN R. A. P. Polycystic disease of the kidneys and intracranial aneurysms. The etiology and interrelationship of these conditions: review of recent literature and report of seven cases in which both conditions coexisted. Glasgow Med J. 1951 Dec;32(12):333–348. [PMC free article] [PubMed] [Google Scholar]
  6. Bansal B. C., Gupta R. R., Bansal M. R., Prakash C. Serum lipids and uric acid relationship in ischemic thrombotic cerebrovascular disease. Stroke. 1975 May-Jun;6(3):304–307. doi: 10.1161/01.str.6.3.304. [DOI] [PubMed] [Google Scholar]
  7. Barker W. H., Feldt K. S., Feibel J. H. Community surveillance of stroke in persons under 70 years old: contribution of uncontrolled hypertension. Am J Public Health. 1983 Mar;73(3):260–265. doi: 10.2105/ajph.73.3.260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Barnett H. J., Boughner D. R., Taylor D. W., Cooper P. E., Kostuk W. J., Nichol P. M. Further evidence relating mitral-valve prolapse to cerebral ischemic events. N Engl J Med. 1980 Jan 17;302(3):139–144. doi: 10.1056/NEJM198001173020303. [DOI] [PubMed] [Google Scholar]
  9. Barnett H. J., Jones M. W., Boughner D. R., Kostuk W. J. Cerebral ischemic events associated with prolapsing mitral valve. Arch Neurol. 1976 Nov;33(11):777–782. doi: 10.1001/archneur.1976.00500110045008. [DOI] [PubMed] [Google Scholar]
  10. Baum H. M., Goldstein M. Cerebrovascular disease type specific mortality: 1968-1977. Stroke. 1982 Nov-Dec;13(6):810–817. doi: 10.1161/01.str.13.6.810. [DOI] [PubMed] [Google Scholar]
  11. Caplan L. R., Baker R. Extrancranial occlusive vascular disease: does size matter? Stroke. 1980 Jan-Feb;11(1):63–66. doi: 10.1161/01.str.11.1.63. [DOI] [PubMed] [Google Scholar]
  12. Caplan L. R., Hier D. B., Banks G. Current concepts of cerebrovascular disease--stroke: stroke and drug abuse. Stroke. 1982 Nov-Dec;13(6):869–872. doi: 10.1161/01.str.13.6.869. [DOI] [PubMed] [Google Scholar]
  13. Christie D. Stroke in Melbourne, Australia: an epidemiological study. Stroke. 1981 Jul-Aug;12(4):467–469. doi: 10.1161/01.str.12.4.467. [DOI] [PubMed] [Google Scholar]
  14. Cooper R., Stamler J., Dyer A., Garside D. The decline in mortality from coronary heart disease, U.S.A., 1968--1975. J Chronic Dis. 1978;31(12):709–720. doi: 10.1016/0021-9681(78)90055-3. [DOI] [PubMed] [Google Scholar]
  15. Cullen K. J., McCall M. G., Stenhouse N. S. Changing mortality due to strokes in men following treatment of Busselton hypertensives 1967-77. Int J Epidemiol. 1979 Sep;8(3):213–217. doi: 10.1093/ije/8.3.213. [DOI] [PubMed] [Google Scholar]
  16. Darlington L. G., Slack J., Scott J. T. Vascular mortality in patients with gout and in their families. Ann Rheum Dis. 1983 Jun;42(3):270–273. doi: 10.1136/ard.42.3.270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Durward Q. J., Ferguson G. G., Barr H. W. The natural history of asymptomatic carotid bifurcation plaques. Stroke. 1982 Jul-Aug;13(4):459–464. doi: 10.1161/01.str.13.4.459. [DOI] [PubMed] [Google Scholar]
  18. Fogelholm R., Aho K. Ischaemic cerebrovascular disease in young adults. 2. Serum cholesterol and triglyceride values. Acta Neurol Scand. 1973;49(4):428–433. doi: 10.1111/j.1600-0404.1973.tb01315.x. [DOI] [PubMed] [Google Scholar]
  19. Folsom A. R., Luepker R. V., Gillum R. F., Jacobs D. R., Prineas R. J., Taylor H. L., Blackburn H. Improvement in hypertension detection and control from 1973-1974 to 1980-1981. The Minnesota Heart Survey experience. JAMA. 1983 Aug 19;250(7):916–921. [PubMed] [Google Scholar]
  20. Freis E. D. The Veterans Administration cooperative study on antihypertensive agents. Implications for stroke prevention. Stroke. 1974 Jan-Feb;5(1):76–77. doi: 10.1161/01.str.5.1.76. [DOI] [PubMed] [Google Scholar]
  21. GORDON T. Mortality experience among the Japanese in the United States, Hawaii, and Japan. Public Health Rep. 1957 Jun;72(6):543–553. [PMC free article] [PubMed] [Google Scholar]
  22. Garcia J. H., Ben-David E., Conger K. A., Geer J. C., Hollander W. Arterial hypertension injures brain capillaries. Definition of the lesions. Possible pathogenesis. Stroke. 1981 Jul-Aug;12(4):410–413. doi: 10.1161/01.str.12.4.410. [DOI] [PubMed] [Google Scholar]
  23. Garraway W. M., Whisnant J. P., Furlan A. J., Phillips L. H., 2nd, Kurland L. T., O'Fallon W. M. The declining incidence of stroke. N Engl J Med. 1979 Mar 1;300(9):449–452. doi: 10.1056/NEJM197903013000901. [DOI] [PubMed] [Google Scholar]
  24. Garraway W. M., Whisnant J. P., Kurland L. T., O'Fallon W. M. Changing pattern of cerebral infarction: 1945--1974. Stroke. 1979 Nov-Dec;10(6):657–663. doi: 10.1161/01.str.10.6.657. [DOI] [PubMed] [Google Scholar]
  25. Gertler M. M., Leetma H. E., Koutrouby R. J., Johnson E. D. The assessment of insulin, glucose and lipids in ischemic thrombotic cerebrovascular disease. Stroke. 1975 Jan-Feb;6(1):77–84. doi: 10.1161/01.str.6.1.77. [DOI] [PubMed] [Google Scholar]
  26. Goldner M. G., Knatterud G. L., Prout T. E. Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. 3. Clinical implications of UGDP results. JAMA. 1971 Nov;218(9):1400–1410. [PubMed] [Google Scholar]
  27. Gordon P. C. The epidemiology of cerebral vascular disease in Canada: an analysis of mortality data. Can Med Assoc J. 1966 Nov 12;95(20):1004–1011. [PMC free article] [PubMed] [Google Scholar]
  28. Gordon T., Kannel W. B. Predisposition to atherosclerosis in the head, heart, and legs. The Framingham study. JAMA. 1972 Aug 14;221(7):661–666. [PubMed] [Google Scholar]
  29. Gordon Tavia. Further mortality experience among Japanese Americans. Public Health Rep. 1967 Nov;82(11):973–984. [PMC free article] [PubMed] [Google Scholar]
  30. HAMMOND E. C. SMOKING IN RELATION TO MORTALITY AND MORBIDITY. FINDINGS IN FIRST THIRTY-FOUR MONTHS OF FOLLOW-UP IN A PROSPECTIVE STUDY STARTED IN 1959. J Natl Cancer Inst. 1964 May;32:1161–1188. [PubMed] [Google Scholar]
  31. Haberman S., Capildeo R., Rose F. C. Diverging trends in cerebrovascular disease and ischaemic heart disease mortality. Stroke. 1982 Sep-Oct;13(5):582–589. doi: 10.1161/01.str.13.5.582. [DOI] [PubMed] [Google Scholar]
  32. Hammond E. C. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed] [Google Scholar]
  33. Handler C. E., Perkin G. D. Sickle cell trait and multiple cerebral infarctions. J R Soc Med. 1982 Jul;75(7):550–553. doi: 10.1177/014107688207500713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Hanson M. R., Conomy J. P., Hodgman J. R. Brain events associated with mitral valve prolapse. Stroke. 1980 Sep-Oct;11(5):499–506. doi: 10.1161/01.str.11.5.499. [DOI] [PubMed] [Google Scholar]
  35. Hart R. G., Easton J. D. Mitral valve prolapse and cerebral infarction. Stroke. 1982 Jul-Aug;13(4):429–430. doi: 10.1161/01.str.13.4.429. [DOI] [PubMed] [Google Scholar]
  36. Herman B., Leyten A. C., van Luijk J. H., Frenken C. W., Op de Coul A. A., Schulte B. P. An evaluation of risk factors for stroke in a Dutch community. Stroke. 1982 May-Jun;13(3):334–339. doi: 10.1161/01.str.13.3.334. [DOI] [PubMed] [Google Scholar]
  37. Heyden S., Heiss G., Heyman A., Tyroler A. H., Hames C. G., Patzschke U., Manegold C. Cardiovascular mortality in transient ischemic attacks. Stroke. 1980 May-Jun;11(3):252–255. doi: 10.1161/01.str.11.3.252. [DOI] [PubMed] [Google Scholar]
  38. Hillbom M., Kaste M. Ethanol intoxication: a risk factor for ischemic brain infarction in adolescents and young adults. Stroke. 1981 Jul-Aug;12(4):422–425. doi: 10.1161/01.str.12.4.422. [DOI] [PubMed] [Google Scholar]
  39. Joensen P. Stroke in an isolated population. Incidence on the Faroes during 1962-1975. Acta Med Scand. 1982;212(5):309–311. [PubMed] [Google Scholar]
  40. Jones H. R., Jr, Naggar C. Z., Seljan M. P., Downing L. L. Mitral valve prolapse and cerebral ischemic events. A comparison between a neurology population with stroke and a cardiology population with mitral valve prolapse observed for five years. Stroke. 1982 Jul-Aug;13(4):451–453. doi: 10.1161/01.str.13.4.451. [DOI] [PubMed] [Google Scholar]
  41. Joossens J. V., Geboers J. Salt and hypertension. Prev Med. 1983 Jan;12(1):53–59. doi: 10.1016/0091-7435(83)90171-8. [DOI] [PubMed] [Google Scholar]
  42. Kagan A., Popper J. S., Rhoads G. G. Factors related to stroke incidence in Hawaii Japanese men. The Honolulu Heart Study. Stroke. 1980 Jan-Feb;11(1):14–21. doi: 10.1161/01.str.11.1.14. [DOI] [PubMed] [Google Scholar]
  43. Kahn H. A. The Dorn study of smoking and mortality among U.S. veterans: report on eight and one-half years of observation. Natl Cancer Inst Monogr. 1966 Jan;19:1–125. [PubMed] [Google Scholar]
  44. Kannel W. B., Dawber T. R., McGee D. L. Perspectives on systolic hypertension. The Framingham study. Circulation. 1980 Jun;61(6):1179–1182. doi: 10.1161/01.cir.61.6.1179. [DOI] [PubMed] [Google Scholar]
  45. Kannel W. B., Dawber T. R., Sorlie P., Wolf P. A. Components of blood pressure and risk of atherothrombotic brain infarction: the Framingham study. Stroke. 1976 Jul-Aug;7(4):327–331. doi: 10.1161/01.str.7.4.327. [DOI] [PubMed] [Google Scholar]
  46. Kannel W. B., Sorlie P., Gordon T. Labile hypertension: a faulty concept? The Framingham study. Circulation. 1980 Jun;61(6):1183–1187. doi: 10.1161/01.cir.61.6.1183. [DOI] [PubMed] [Google Scholar]
  47. Kannel W. B., Wolf P. A., Dawber T. R. An evaluation of the epidemiology of atherothrombotic brain infarction. Milbank Mem Fund Q Health Soc. 1975 Fall;53(4):405–448. [PubMed] [Google Scholar]
  48. Kannel W. B., Wolf P. A., McGee D. L., Dawber T. R., McNamara P., Castelli W. P. Systolic blood pressure, arterial rigidity, and risk of stroke. The Framingham study. JAMA. 1981 Mar 27;245(12):1225–1229. [PubMed] [Google Scholar]
  49. Kannel W. B., Wolf P. A., Verter J., McNamara P. M. Epidemiologic assessment of the role of blood pressure in stroke. The Framingham study. JAMA. 1970 Oct 12;214(2):301–310. [PubMed] [Google Scholar]
  50. Kimura N. Changing patterns of coronary heart disease, stroke, and nutrient intake in Japan. Prev Med. 1983 Jan;12(1):222–227. doi: 10.1016/0091-7435(83)90198-6. [DOI] [PubMed] [Google Scholar]
  51. Matsumoto N., Whisnant J. P., Kurland L. T., Okazaki H. Natural history of stroke in Rochester, Minnesota, 1955 through 1969: an extension of a previous study, 1945 through 1954. Stroke. 1973 Jan-Feb;4(1):20–29. doi: 10.1161/01.str.4.1.20. [DOI] [PubMed] [Google Scholar]
  52. Merkel K. H., Ginsberg P. L., Parker J. C., Jr, Post M. J. Cerebrovascular disease in sickle cell anemia: a clinical, pathological and radiological correlation. Stroke. 1978 Jan-Feb;9(1):45–52. doi: 10.1161/01.str.9.1.45. [DOI] [PubMed] [Google Scholar]
  53. Mitsuyama Y., Thompson L. R., Hayashi T., Lee K. K., Keehn R. J., Resch J. A., Steer A. Autopsy study of cerebrovascular disease in Japanese men who lived in Hiroshima, Japan, and Honolulu, Hawaii. Stroke. 1979 Jul-Aug;10(4):389–395. doi: 10.1161/01.str.10.4.389. [DOI] [PubMed] [Google Scholar]
  54. Mohr J. P., Caplan L. R., Melski J. W., Goldstein R. J., Duncan G. W., Kistler J. P., Pessin M. S., Bleich H. L. The Harvard Cooperative Stroke Registry: a prospective registry. Neurology. 1978 Aug;28(8):754–762. doi: 10.1212/wnl.28.8.754. [DOI] [PubMed] [Google Scholar]
  55. Murai A., Tanaka T., Miyahara T., Kameyama M. Lipoprotein abnormalities in the pathogenesis of cerebral infarction and transient ischemic attack. Stroke. 1981 Mar-Apr;12(2):167–172. doi: 10.1161/01.str.12.2.167. [DOI] [PubMed] [Google Scholar]
  56. Mérei F. T., Gallyas F., Horváth Z. Elastic elements in the media and adventitia of human intracranial extracerebral arteries. Stroke. 1980 Jul-Aug;11(4):329–336. doi: 10.1161/01.str.11.4.329. [DOI] [PubMed] [Google Scholar]
  57. Nichaman M. Z., Hamilton H. B., Kagan A., Grier T., Sacks T., Syme S. L. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: distribution of biochemical risk factors. Am J Epidemiol. 1975 Dec;102(6):491–501. doi: 10.1093/oxfordjournals.aje.a112187. [DOI] [PubMed] [Google Scholar]
  58. Ostfeld A. M. A review of stroke epidemiology. Epidemiol Rev. 1980;2:136–152. doi: 10.1093/oxfordjournals.epirev.a036219. [DOI] [PubMed] [Google Scholar]
  59. Ostfeld A. M., Shekelle R. B., Klawans H., Tufo H. M. Epidemiology of stroke in an elderly welfare population. Am J Public Health. 1974 May;64(5):450–458. doi: 10.2105/ajph.64.5.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. PHEAR D. N. Occlusion of the coronary and the cerebral arteries--two separate and distinct disease processes. Med J Aust. 1962 Feb 3;49(1):149–153. [PubMed] [Google Scholar]
  61. Paffenbarger R. S., Gima A. S., Laughlin E., Black R. A. Characteristics of longshoremen related fatal coronary heart disease and stroke. Am J Public Health. 1971 Jul;61(7):1362–1370. doi: 10.2105/ajph.61.7.1362. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Paffenbarger R. S., Jr, Wing A. L. Characteristics in youth predisposing to fatal stroke in later years. Lancet. 1967 Apr 8;1(7493):753–754. doi: 10.1016/s0140-6736(67)91367-0. [DOI] [PubMed] [Google Scholar]
  63. Paffenbarger R. S., Williams J. L. Chronic disease in former college students v. Early precursors of fatal stroke. Am J Public Health Nations Health. 1967 Aug;57(8):1290–1299. doi: 10.2105/ajph.57.8.1290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  64. Pickering N. J., Brody J. I., Barrett M. J. von Willebrand syndromes and mitral-valve prolapse; linked mesenchymal dysplasias. N Engl J Med. 1981 Jul 16;305(3):131–134. doi: 10.1056/NEJM198107163050303. [DOI] [PubMed] [Google Scholar]
  65. Pulsinelli W. A., Levy D. E., Sigsbee B., Scherer P., Plum F. Increased damage after ischemic stroke in patients with hyperglycemia with or without established diabetes mellitus. Am J Med. 1983 Apr;74(4):540–544. doi: 10.1016/0002-9343(83)91007-0. [DOI] [PubMed] [Google Scholar]
  66. Rabkin S. W., Mathewson F. A., Tate R. B. The relation of blood pressure to stroke prognosis. Ann Intern Med. 1978 Jul;89(1):15–20. doi: 10.7326/0003-4819-89-1-15. [DOI] [PubMed] [Google Scholar]
  67. Rhoads G. G., Popper J. S., Kagan A., Yano K. Incidence of transient cerebral ischemic attack in Hawaii Japanese men. The Honolulu Heart Study. Stroke. 1980 Jan-Feb;11(1):21–26. doi: 10.1161/01.str.11.1.21. [DOI] [PubMed] [Google Scholar]
  68. Riddle M. C., Hart J. Hyperglycemia, recognized and unrecognized, as a risk factor for stroke and transient ischemic attacks. Stroke. 1982 May-Jun;13(3):356–359. doi: 10.1161/01.str.13.3.356. [DOI] [PubMed] [Google Scholar]
  69. Sacco R. L., Wolf P. A., Kannel W. B., McNamara P. M. Survival and recurrence following stroke. The Framingham study. Stroke. 1982 May-Jun;13(3):290–295. doi: 10.1161/01.str.13.3.290. [DOI] [PubMed] [Google Scholar]
  70. Salonen J. T., Puska P. Relation of serum cholesterol and triglycerides to the risk of acute myocardial infarction, cerebral stroke and death in eastern Finnish male population. Int J Epidemiol. 1983 Mar;12(1):26–31. doi: 10.1093/ije/12.1.26. [DOI] [PubMed] [Google Scholar]
  71. Salonen J. T., Puska P., Tuomilehto J., Homan K. Relation of blood pressure, serum lipids, and smoking to the risk of cerebral stroke. A longitudinal study in Eastern Finland. Stroke. 1982 May-Jun;13(3):327–333. doi: 10.1161/01.str.13.3.327. [DOI] [PubMed] [Google Scholar]
  72. Salonen J. T., Puska P., Tuomilehto J. Physical activity and risk of myocardial infarction, cerebral stroke and death: a longitudinal study in Eastern Finland. Am J Epidemiol. 1982 Apr;115(4):526–537. doi: 10.1093/oxfordjournals.aje.a113334. [DOI] [PubMed] [Google Scholar]
  73. Sandok B. A., Giuliani E. R. Cerebral ischemic events in patients with mitral valve prolapse. Stroke. 1982 Jul-Aug;13(4):448–450. doi: 10.1161/01.str.13.4.448. [DOI] [PubMed] [Google Scholar]
  74. Scharf R. E., Hennerici M., Bluschke V., Lueck J., Kladetzky R. G. Cerebral ischemia in young patients: it is associated with mitral valve prolapse and abnormal platelet activity in vivo? Stroke. 1982 Jul-Aug;13(4):454–458. doi: 10.1161/01.str.13.4.454. [DOI] [PubMed] [Google Scholar]
  75. Schoenberg B. S., Mellinger J. F., Schoenberg D. G. Cerebrovascular disease in infants and children: a study of incidence, clinical features, and survival. Neurology. 1978 Aug;28(8):763–768. doi: 10.1212/wnl.28.8.763. [DOI] [PubMed] [Google Scholar]
  76. Shekelle R. B., Ostfeld A. M., Klawans H. L., Jr Hypertension and risk of stroke in an elderly population. Stroke. 1974 Jan-Feb;5(1):71–75. doi: 10.1161/01.str.5.1.71. [DOI] [PubMed] [Google Scholar]
  77. Smith D. L., McKnight T. E., Jr TIAs, completed strokes, and mitral valve prolapse. South Med J. 1981 Dec;74(12):1454–1456. doi: 10.1097/00007611-198112000-00010. [DOI] [PubMed] [Google Scholar]
  78. Soltero I., Liu K., Cooper R., Stamler J., Garside D. Trends in mortality from cerebrovascular diseases in the United States, 1960 to 1975. Stroke. 1978 Nov-Dec;9(6):549–558. doi: 10.1161/01.str.9.6.549. [DOI] [PubMed] [Google Scholar]
  79. Spaccavento L. J., Solomon G. D. Migraine as an etiology of stroke in young adults. Headache. 1984 Jan;24(1):19–22. doi: 10.1111/j.1526-4610.1984.hed2401019.x. [DOI] [PubMed] [Google Scholar]
  80. Stallones R. A. Epidemiology of cerebrovascular disease. A review. J Chronic Dis. 1965 Aug;18(8):859–872. doi: 10.1016/0021-9681(65)90022-6. [DOI] [PubMed] [Google Scholar]
  81. Sundt T. M., Jr, Sharbrough F. W., Anderson R. E., Michenfelder J. D. Cerebral blood flow measurements and electroencephalograms during carotid endarterectomy. J Neurosurg. 1974 Sep;41(3):310–320. doi: 10.3171/jns.1974.41.3.0310. [DOI] [PubMed] [Google Scholar]
  82. Sundt T. M., Jr, Sharbrough F. W., Piepgras D. G., Kearns T. P., Messick J. M., Jr, O'Fallon W. M. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia. Mayo Clin Proc. 1981 Sep;56(9):533–543. [PubMed] [Google Scholar]
  83. Tanaka H., Tanaka Y., Hayashi M., Ueda Y., Date C., Baba T., Shoji H., Horimoto T., Owada K. Secular trends in mortality for cerebrovascular diseases in Japan, 1960 to 1979. Stroke. 1982 Sep-Oct;13(5):574–581. doi: 10.1161/01.str.13.5.574. [DOI] [PubMed] [Google Scholar]
  84. Tanaka H., Ueda Y., Hayashi M., Date C., Baba T., Yamashita H., Shoji H., Tanaka Y., Owada K., Detels R. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke. 1982 Jan-Feb;13(1):62–73. doi: 10.1161/01.str.13.1.62. [DOI] [PubMed] [Google Scholar]
  85. Terrence C. F., Rao G. R. Triglycerides as a risk factor in extracranial atherosclerotic cerebrovascular disease. Angiology. 1983 Jul;34(7):452–460. doi: 10.1177/000331978303400705. [DOI] [PubMed] [Google Scholar]
  86. Tharakan J., Ahuja G. K., Manchanda S. C., Khanna A. Mitral valve prolapse and cerebrovascular accidents in the young. Acta Neurol Scand. 1982 Sep;66(3):295–302. doi: 10.1111/j.1600-0404.1982.tb06848.x. [DOI] [PubMed] [Google Scholar]
  87. Thomas D. J. Whole blood viscosity and cerebral blood flow. Stroke. 1982 May-Jun;13(3):285–287. doi: 10.1161/01.str.13.3.285. [DOI] [PubMed] [Google Scholar]
  88. Tohgi H., Yamanouchi H., Murakami M., Kameyama M. Importance of the hematocrit as a risk factor in cerebral infarction. Stroke. 1978 Jul-Aug;9(4):369–374. doi: 10.1161/01.str.9.4.369. [DOI] [PubMed] [Google Scholar]
  89. Toole J. F., Yuson C. P., Janeway R., Johnston F., Davis C., Cordell A. R., Howard G. Transient ischemic attacks: a prospective study of 225 patients. Neurology. 1978 Aug;28(8):746–753. doi: 10.1212/wnl.28.8.746. [DOI] [PubMed] [Google Scholar]
  90. Ueda K., Omae T., Hirota Y., Takeshita M., Katsuki S., Tanaka K., Enjoji M. Decreasing trend in incidence and mortality from stroke in Hisayama residents, Japan. Stroke. 1981 Mar-Apr;12(2):154–160. doi: 10.1161/01.str.12.2.154. [DOI] [PubMed] [Google Scholar]
  91. Vaisrub S. Labile and systolic hypertension: a reappraisal. JAMA. 1981 Mar 27;245(12):1250–1250. doi: 10.1001/jama.1981.03310370042024. [DOI] [PubMed] [Google Scholar]
  92. Velican C., Anghelescu M., Velican D. Preliminary study on the natural history of cerebral atherosclerosis. Med Interne. 1981 Apr-Jun;19(2):137–145. [PubMed] [Google Scholar]
  93. Walsh P. N., Kansu T. A., Corbett J. J., Savion P. J., Goldburgh W. P., Schatz N. J. Platelets, thromboembolism and mitral valve prolapse. Circulation. 1981 Mar;63(3):552–559. doi: 10.1161/01.cir.63.3.552. [DOI] [PubMed] [Google Scholar]
  94. Whelton P. K. Declining mortality from hypertension and stroke. South Med J. 1982 Jan;75(1):33–38. doi: 10.1097/00007611-198201000-00010. [DOI] [PubMed] [Google Scholar]
  95. Wolf P. A., Dawber T. R., Thomas H. E., Jr, Kannel W. B. Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology. 1978 Oct;28(10):973–977. doi: 10.1212/wnl.28.10.973. [DOI] [PubMed] [Google Scholar]
  96. Wolf P. A., Kannel W. B., McNamara P. M., Gordon T. The role of impaired cardiac function in atherothrombotic brain infarction: the Framingham study. Am J Public Health. 1973 Jan;63(1):52–58. doi: 10.2105/ajph.63.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  97. Wood D. H. Cerebrovascular complications of sickle cell anemia. Stroke. 1978 Jan-Feb;9(1):73–75. doi: 10.1161/01.str.9.1.73. [DOI] [PubMed] [Google Scholar]
  98. Worth R. M., Kato H., Rhoads G. G., Kagan K., Syme S. L. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality. Am J Epidemiol. 1975 Dec;102(6):481–490. doi: 10.1093/oxfordjournals.aje.a112186. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES