RESUMEN
We carried out a case control study at the University Hospital of Pointe-a-Pitre, Guadeloupe, during eight months. Seventy patients with ischaemic stroke and seventy age- and sex matched controls were involved. A standard questionnaire reported clinical characteristics and medical history. Seventy-six per cent of patients suffered from hypertension. Obesity and diabetes were more frequent in the case group than in the control group. Serum creatinine concentration (86 vs 74umol/l; p <0.001), total cholesterol (5.9 vs 5.2 mmol/l; p < 0.001), apolipoprotein B (1.2 vs 1.0 g/l' p < 0.001) and lipoprotein (a) (82 vs 48 mg/dl; p< 0.001) were significantly higher in patients than controls. Multiple logistic regression analysis revealed that in addition to serum creatinine, serum apolipoprotein B, hypertension, obesity, serum lipoprotein (a) and diabetes mellitus were associated independently and significantly with ischaemic stroke. These findings have implications for clinical practice and further research particularly with respect to serum creatinine concentration as a marker of renal damage from hypertension and as risk factor itself for cerebrovascular disease.(Au)
Asunto(s)
Humanos , Creatinina/sangre , Accidente Cerebrovascular/sangre , Colesterol/sangre , Diabetes Mellitus/complicaciones , Diabetes Mellitus/epidemiología , Hipertensión/complicaciones , Hipertensión/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Estudios de Casos y Controles , Encuestas y Cuestionarios , Prevalencia , Factores de Riesgo , Biomarcadores/sangre , Accidente Cerebrovascular/etiología , Guadalupe/epidemiología , Modelos LogísticosRESUMEN
We carried out a case control study at the University Hospital of Pointe-Ó-Pitre, Guadeloupe, during eight months. Seventy patients with ischaemic stroke and seventy age- and sex-matched controls were involved. A standard questionnaire reported clinical characteristics and medical history. Seventy-six per cent of patients suffered from hypertension. Obesity and diabetes were more frequent in the case group than in the control group. Serum creatinine concentration (86 vs 74 mumol/l; p < 0.001), total cholesterol (5.9 vs. 5.2 mmol/l; p < 0.001), apolipoprotein B (1.2 vs 1.0 g/l; p < 0.001) and lipoprotein (a) (82 vs 48 mg/dl; p < 0.001) were significantly higher in patients than controls. Multiple logistic regression analysis revealed that in addition to serum creatinine, serum apolipoprotein B, hypertension, obesity, serum lipoprotein (a) and diabetes mellitus were associated independently and significantly with ischaemic stroke. These findings have implications for clinical practice and further research particularly with respect to serum creatinine concentration as a marker of renal damage from hypertension and as a risk factor itself for cerebrovascular disease.
Asunto(s)
Creatinina , Accidente Cerebrovascular , Estudios de Casos y Controles , Colesterol , Prevalencia , Factores de Riesgo , Guadalupe , Accidente Cerebrovascular , Diabetes Mellitus , Obesidad , Hipertensión/complicaciones , Hipertensión/epidemiología , Biomarcadores/sangre , Modelos Logísticos , Encuestas y CuestionariosRESUMEN
Stroke is frequent in Guadeloupe and represents the first cause of mortality in the >35 year age group. A major risk factor of stroke, hypertension, is also very common (23 percent of the adult population). The French West Indies (FWI) has specific demographic characteristics because its population originated from various regions of the world, mainly Africa, and has a higher socioeconomic level than the other tropical regions. These circumstances provide an interesting background for the study of the epidemiology of stroke and its risk factors. A case control study with 90 stroke patients and 77 controls matched for age and ethnicity was carried out during six months at the University Hospital of Pointe-a-Pitre, FWI. A questionnaire was used to collect information on demographics, history of smoking and alcohol use and current medical history. Serum creatinine, C-reactive protein and lipid profile were quantified. Among stroke patients 48/90 (63.6 percent) were ischaemic, and 58/90 (75.3 percent) had previous hypertension. Obesity and diabetes were more frequent in the cases than in the controls. Serum creatinine concentration, serum total cholesterol, and apolipoprotein-B were significantly higher in patients than controls [83 umol/l vs 73 (p<0.0003) for creatinine, 5.7 mmol/l vs 5.2 (p<0.008) for cholesterol, and 1.2 g/l vs 1.0 (p<0.001) for apolipoprotein-B]. A multiple logistic regression analysis revealed that, in addition to hypertension and obesity, a high serum apolipoprotein-B concentration (>75 umol/l), and a high serum apolipoprotein-B concentration (>Ig/I) were independent and significant risk factors of stroke.(AU)