Table 14-2.
Modifiable Stroke Risk Factors
| Factor | Prevalence, % | PAR, %* | RR |
|---|---|---|---|
| Cigarette smoking | |||
| Overall | 19.8 | 12–14† | 1.9 |
| Men | 22.3 | ||
| Women | 17.4 | ||
| Hypertension | ‡ | 8 | |
| Ages 20–34 y | |||
| Men | 13.4 | 99 | |
| Women | 6.2 | 98 | |
| Ages 35–44 y | |||
| Men | 23.2 | 99 | |
| Women | 16.5 | 106 | |
| Ages 45–54 y | |||
| Men | 36.2 | 100 | |
| Women | 35.9 | 103 | |
| Ages 55–64 y | |||
| Men | 53.7 | 100 | |
| Women | 55.8 | 102 | |
| Ages 65–74 y | |||
| Men | 64.7 | 100 | |
| Women | 69.6 | 101 | |
| Ages ≥75 y | |||
| Men | 64.1 | 100 | |
| Women | 76.4 | 101 | |
| Diabetes | 7.3 | 5–27 | 1.8–6.0 |
| High total cholesterol | Data calculated for highest quintile (20%) vs lowest quintile | 9.1 (5.7–13.8) | 1.5 (95% CI, 1.3–1.8) |
| Continuous risk for ischemic stroke | … | 1.25 per 1-mmol/L (38.7 mg/dL) increase | |
| Low HDL cholesterol | |||
| <40 mg/dL | |||
| Men | 35 | ||
| Women | 15 | ||
| Data calculated for highest quintile (20%) vs lowest quintile | 23.7 | 0.4 | |
| <35 mg/dL | 26 | 20.6 (10.1–30.7) | 2.00 (95% CI, 1.43–2.70) |
| Continuous risk for ischemic stroke | ≈0.5–0.6 for each 1-mmol/L increase | ||
| AF (nonvalvular) | |||
| Overall age, y | |||
| 50–59 | 0.5 | 1.5 | 4.0 |
| 60–69 | 1.8 | 2.8 | 2.6 |
| 70–79 | 4.8 | 9.9 | 3.3 |
| 80–89 | 8.8 | 23.5 | 4.5 |
| Asymptomatic carotid stenosis | 2–8 | 2–7§ | 2.0 |
| Sickle cell disease | 0.25 (of blacks) | … | 200–400|| |
| Postmenopausal hormone therapy | 25 (Women 50–74 y of age) | 9 | 1.4 |
| Oral contraceptive use | 13 (women 25–44 y) | 9.4 | 2.3 |
| Dietary factors | |||
| Na intake >2300 mg | 75–90 | Unknown | Unknown |
| K intake <4700 mg | 90–99 | Unknown | Unknown |
| Physical inactivity | 25 | 30 | 2.7 |
| Obesity | 1.39 Stroke death per increase of 5 kg/m2 | ||
| Men | 33.3 | ||
| Women | 35.3 | ||
| CHD | |||
| Men | 8.4 | 5.8 | 1.73 (1.68–1.78) |
| Women | 5.6 | 3.9¶ | 1.55 (1.17–2.07) |
| Heart failure | |||
| Men | 2.6 | 1.4 | |
| Women | 2.1 | 1.1¶ | |
| Peripheral arterial disease | 4.9 | 3.0¶ | |
PAR indicates population attributable risk; RR, relative risk; CI, confidence interval; HDL, high-density lipoprotein; AF, atrial fibrillation; and CHD, coronary heart disease.
PAR is the proportion of ischemic stroke in the population that can be attributed to a particular risk factor (see Goldstein et al62 for formula).
PAR is for stroke deaths, not ischemic stroke incidence.
PAR percent=100×{[prevalence (RR−1)/prevalence (RR−1) +1]}.
Calculated on the basis of referenced data provided in the table or text.
Relative to stroke risk in children without sickle cell disease.
Calculated on the basis of point estimates of referenced data provided in the table. For peripheral arterial disease, calculation was based on average RR for men and women.
Adapted from Goldstein et al.62