Different risk factor profiles between subtypes of ischemic stroke. A case-control study in Korean men.

Ischemic stroke is composed of subtypes with variable underlying pathogenesis and studies on ischemic stroke as a whole may inadequately evaluate risk factors, being influenced by subtype distribution among studied population. This study aimed to evaluate risk factors associated with individual ischemic stroke subtypes defined by the Trial of ORG10172 in Acute Stroke Treatment. In a case-control study (290 first-ever ischemic stroke cases and 1160 individually matched controls without stroke) nested within Korean male public servants cohort, a range of potential risk factors measured at periodic health surveys prior to the onset of stroke event were examined using conditional logistic regression analysis. Increased risk for large-artery atherosclerosis was associated with hypercholesterolemia (> or = 6.2 mmol/L), hypertension, and smoking. Increased risk for small-artery occlusion was associated with hypertension, hyperglycemia (> or = 7.0 mmol/L), and frequent alcohol intake. No specific risk factor was identified for cardioembolism. For combined ischemic stroke, hypercholesterolemia, hyperglycemia, hypertension, and smoking were associated with the increased risk, but the relative odds were much smaller than those estimated from subtype analysis. Significance of risk factors evaluated for subtypes, rather than ischemic stroke as a whole, should be reflected in preventive efforts against the burden of ischemic stroke.

Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea.

The aim of this study was first, to investigate the prevalence of obesity, abdominal obesity, and clustering of cardiovascular (CVD) risk factors, and secondly, to identify the BMI or waist circumference (WC) level at which clustering increases in South Koreans. A population-based, cross-sectional National Health Examination Survey was carried out in 1998. A total of 8,816 subjects (4,029 men and 4,787 women) aged 15-79 y were selected by stratified multistage probability sampling design. The measurements taken of the subjects included: height, weight, waist and hip circumference, blood pressure, fasting glucose, and lipids. The prevalence of BMI > or = 25 kg/m2 was 25.3% for men and 28.3% for women. The prevalence of WC >90 cm in men, and >80 cm in women was 18.5%, and 38.5%, respectively. Clustering of 3 or more CVD risk factors was 22.7% in men ad 21.7% in women. Using <21 kg/m2; as a referent, subjects with BMI of 23 kg/m2; and 27 kg/m2; had an odds ratio of 3.5 and 10.2 in men, and 3.1 and 6.7 in women, respectively for clustering of CVD risk factors. Using <65 cm as a referent, subjects with a WC of > or = 90 cm in men and > or = 85 cm in women had an odds ratio of 13.4, and 13.6, respectively for clustering of CVD risk factors. Considering the significant associations between clustering of CVD risk factors and BMI or WC, the present study suggests that high prevalence of overweight may have important implications for the health care system, even at a lower level of BMI or WC.