Stroke risk factors. Population case-control study in the Foral Community of Navarre

Abstract

Background. To determine the prevalence of different risk factors in patients with cerebrovascular disease of a population in the Foral Community of Navarre, and to compare this with a control group with the same characteristics. Patients and methods. Population-based case-control study of a basic health zone (12,200 inhabitants). We included 91 patients, diagnosed with the first episode of cerebrovascular disease (1999-2003), and 182 controls (2 per case), paired by age and sex in the same time period. Results. The estimation of the incidence of cerebrovascular disease in our series is between 160 and 190 cases/100,000 inhabitants and year. The prevalence of arterial hypertension in the cerebrovascular disease group is 75%; 25% have previously suffered a transient ischemic attack and 31% had atrial fibrillation. Other vascular risk factors such as diabetes or hyperlipidaemia are present in 33% and 38%, respectively. Other risk factors are smoking (25%), ischemic cardiopathy (14%) and family antecedents of cerebrovascular disease (21.3%). An association has been found between cerebrovascular disease and arterial hypertension (OR=2.2; 95% CI = 1.2-4.0), personal antecedent of transient ischemic attack (OR=4.0; 95% CI 1.9-8.5), atrial fibrillation (OR=2.8; 95% CI 1.4-5.3), diabetes mellitus (OR=2.5; 95% CI 1.3-4-6). Conclusions. The results obtained on a population basis - not only a hospital basis - will help us to obtain a more precise understanding of the aetiopathogeny of cerebrovascular disease. The results observed for arterial hypertension, diabetes mellitus and hyperlipidaemia, since they are modifiable risk factors; underline the importance of primary prevention. Similarly, such measures should be strengthened in the subjects with atrial fibrillation. The association with prior diagnosis of transient ischemic attack strengthens the need for adjusting the secondary prevention measures in this group of patients.