Risk Factors for Stroke

Abstract

BACKGROUND: Stroke is the second leading cause of death in the world. An absence of a definite treatment for stroke further emphasizes the importance of its prevention. This has led to a tremendous amount of research on the identification of the risk factors for stroke. Because of the publication of an enormous number of articles on this subject, a periodic review is always needed. This review has been conducted with similar objectives.

METHODS: An effort has been mad to review the results of all major large scale studies which have been previously published on the identification of risk factors for stroke. We have also searched for the studies that have identified new risk factors for stroke.

RESULTS: The risk factors for stroke identified in previous studies are hypertension, cigarette smoking, diabetes mellitus, atrial fibrillation, a history of myocardial infarction, asymptomatic carotid stenosis, transient ischemic attack, race, ethnicity, geographical location, and physical inactivity. The role of increased cholesterol as a risk factor for stroke could not be established. Though both light and heavy alcohol drinking were found to be associated with an increased incidence of hemorrhagic stroke, a J-shaped relationship was observed regarding ischemic stroke, with a somewhat protective effect of alcohol in light drinkers to an elevated risk in heavy drinkers. Increased levels of homocysteine in blood, cocaine use, obesity and sleep apnea were the other recently identified risk factors, though more studies are needed to confirm their role.

CONCLUSION: The need for continuous identification and modification of risk factors for stroke is always going to be present. With the modification of the already identified risk factors, stroke incidence has seen a decline all over the world.