Associations of obesity measures with subtypes of ischemic stroke in the ARIC study

Hiroshi Yatsuya, Kazumasa Yamagishi, Kari E. North, Frederick L. Brancati, June Stevens, Aaron R. Folsom

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Associations between obesity and lacunar, nonlacunar thrombotic, and cardioembolic stroke are not firmly established. Methods: Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) were recorded at baseline between 1987 and 1989 in the Atherosclerosis Risk in Communities (ARIC) Study for 13 549 black and white adults who were aged from 45 to 64 years and had no history of cardiovascular disease or cancer. The incidence of ischemic stroke subtypes was ascertained from surveillance of hospital records over a median follow-up of 16.9 years. Cox proportional hazards regression analyses adjusted for age, sex, race, education, smoking status and cigarette years, usual ethanol intake, and leisure time sports index were used to estimate hazard ratios (HRs). Results: The ARIC sample at baseline was 43.8% men and 27.3% blacks; mean age was 53.9 years. Mean BMI, waist circumference, and WHR were 27.7 kg/m2, 96.8 cm, and 0.92, respectively. The associations of lacunar (n = 138), nonlacunar (n = 338), and cardioembolic (n = 122) ischemic stroke incidence with obesity measures were all generally positive and linear. The HRs for the highest versus lowest quintile of the 3 obesity measures ranged from 1.43-2.21 for lacunar stroke, 1.90-2.16 for nonlacunar stroke, and 2.37-2.91 for cardioembolic stroke. Conclusions: Although different pathophysiological mechanisms may exist, the incidences of lacunar, nonlacunar, and cardioembolic stroke were all significantly positively associated with the degree of obesity, regardless of the measure used.

Original languageEnglish
Pages (from-to)347-354
Number of pages8
JournalJournal of Epidemiology
Volume20
Issue number5
DOIs
Publication statusPublished - 03-11-2010
Externally publishedYes

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Atherosclerosis
Obesity
Stroke
Waist-Hip Ratio
Waist Circumference
Incidence
Body Mass Index
Lacunar Stroke
Sex Education
Hospital Records
Leisure Activities
Sports
Ethanol
Cardiovascular Diseases
Smoking
Regression Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Medicine(all)

Cite this

Yatsuya, H., Yamagishi, K., North, K. E., Brancati, F. L., Stevens, J., & Folsom, A. R. (2010). Associations of obesity measures with subtypes of ischemic stroke in the ARIC study. Journal of Epidemiology, 20(5), 347-354. https://doi.org/10.2188/jea.JE20090186
Yatsuya, Hiroshi ; Yamagishi, Kazumasa ; North, Kari E. ; Brancati, Frederick L. ; Stevens, June ; Folsom, Aaron R. / Associations of obesity measures with subtypes of ischemic stroke in the ARIC study. In: Journal of Epidemiology. 2010 ; Vol. 20, No. 5. pp. 347-354.
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Yatsuya, H, Yamagishi, K, North, KE, Brancati, FL, Stevens, J & Folsom, AR 2010, 'Associations of obesity measures with subtypes of ischemic stroke in the ARIC study', Journal of Epidemiology, vol. 20, no. 5, pp. 347-354. https://doi.org/10.2188/jea.JE20090186

Associations of obesity measures with subtypes of ischemic stroke in the ARIC study. / Yatsuya, Hiroshi; Yamagishi, Kazumasa; North, Kari E.; Brancati, Frederick L.; Stevens, June; Folsom, Aaron R.

In: Journal of Epidemiology, Vol. 20, No. 5, 03.11.2010, p. 347-354.

Research output: Contribution to journalArticle

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T1 - Associations of obesity measures with subtypes of ischemic stroke in the ARIC study

AU - Yatsuya, Hiroshi

AU - Yamagishi, Kazumasa

AU - North, Kari E.

AU - Brancati, Frederick L.

AU - Stevens, June

AU - Folsom, Aaron R.

PY - 2010/11/3

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N2 - Background: Associations between obesity and lacunar, nonlacunar thrombotic, and cardioembolic stroke are not firmly established. Methods: Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) were recorded at baseline between 1987 and 1989 in the Atherosclerosis Risk in Communities (ARIC) Study for 13 549 black and white adults who were aged from 45 to 64 years and had no history of cardiovascular disease or cancer. The incidence of ischemic stroke subtypes was ascertained from surveillance of hospital records over a median follow-up of 16.9 years. Cox proportional hazards regression analyses adjusted for age, sex, race, education, smoking status and cigarette years, usual ethanol intake, and leisure time sports index were used to estimate hazard ratios (HRs). Results: The ARIC sample at baseline was 43.8% men and 27.3% blacks; mean age was 53.9 years. Mean BMI, waist circumference, and WHR were 27.7 kg/m2, 96.8 cm, and 0.92, respectively. The associations of lacunar (n = 138), nonlacunar (n = 338), and cardioembolic (n = 122) ischemic stroke incidence with obesity measures were all generally positive and linear. The HRs for the highest versus lowest quintile of the 3 obesity measures ranged from 1.43-2.21 for lacunar stroke, 1.90-2.16 for nonlacunar stroke, and 2.37-2.91 for cardioembolic stroke. Conclusions: Although different pathophysiological mechanisms may exist, the incidences of lacunar, nonlacunar, and cardioembolic stroke were all significantly positively associated with the degree of obesity, regardless of the measure used.

AB - Background: Associations between obesity and lacunar, nonlacunar thrombotic, and cardioembolic stroke are not firmly established. Methods: Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) were recorded at baseline between 1987 and 1989 in the Atherosclerosis Risk in Communities (ARIC) Study for 13 549 black and white adults who were aged from 45 to 64 years and had no history of cardiovascular disease or cancer. The incidence of ischemic stroke subtypes was ascertained from surveillance of hospital records over a median follow-up of 16.9 years. Cox proportional hazards regression analyses adjusted for age, sex, race, education, smoking status and cigarette years, usual ethanol intake, and leisure time sports index were used to estimate hazard ratios (HRs). Results: The ARIC sample at baseline was 43.8% men and 27.3% blacks; mean age was 53.9 years. Mean BMI, waist circumference, and WHR were 27.7 kg/m2, 96.8 cm, and 0.92, respectively. The associations of lacunar (n = 138), nonlacunar (n = 338), and cardioembolic (n = 122) ischemic stroke incidence with obesity measures were all generally positive and linear. The HRs for the highest versus lowest quintile of the 3 obesity measures ranged from 1.43-2.21 for lacunar stroke, 1.90-2.16 for nonlacunar stroke, and 2.37-2.91 for cardioembolic stroke. Conclusions: Although different pathophysiological mechanisms may exist, the incidences of lacunar, nonlacunar, and cardioembolic stroke were all significantly positively associated with the degree of obesity, regardless of the measure used.

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