Risk factors associated with ischaemic stroke in Guadeloupe

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)

Obesity in a health center in Guadeloupe (French West Indies). A case control study - Poster abstract

OBJECTIVE: The aim of this study was to assess prevalence of obesity in a health center in Guadeloupe and analyse the association of known cardiovascular risk factors. MATERIAL AND METHODS: From a total of675 people aged 18 to 75 years attending a health centre between April and September 1999, 79 obese patients (BMI> 30) and 158 non-obese age and sex matched controls were enrolled. Pregnant patients were excluded. Medical histories were obtained by standardised questionnaire. Body mass index (BMI), waist to hip ratio (WHR), and laboratory measurements were done. RESULTS: Among the 675 subjects, prevalenceof overweight (BMI>25 and<30) was 35.4 percent) formen vs 38.9 percent for women and prevalence of obesity (BMI >30) was 9.7 percent for men vs 18.6 percent for women. Results in cases and controls are shown in the table. A logistic regression revealed that sedentary way of life, hypertension and a WHR>0.90 were cardiovascular risk factors significantly and independently associated with obesity. CONCLUSIONS: These results have shown a high percentage of overweight subjects for whom it is necessary to organize the prevention of cardiovascular disease by the control of hypertension, dietary restriction and exercise training. (Au)

Risk factors of stroke in a West Indian population, a case control study

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)