Journal of Biostatistics and Epidemiology 2016. 2(3):111-117.

Risk factors associated with ischemic stroke: A case-control study
Mahdiyeh Khodabandehlou, Mohammad-Ali Mansournia, Masoud Mehrpour, Kourosh Holakouie Naieni


Background & Aim: Stroke is the second common cause of deaths and the third common cause of disability-adjusted life years worldwide in 2010, so knowledge of risk factors within a certain country is an essential step in reducing the stroke rate and resulting disease burden .
Methods & Materials: This was a case–control study to determine and assess risk factors influencing ischemic stroke. In this study, 72 stroke patients hospitalized in Firoozgar Hospital of Tehran city for ischemic stroke from June 2012 to September 2013 were considered as a case group, and 72 individuals were selected as a control group that referred to the same laboratory of the hospital due to the causes other than risk factors for cardiovascular disease. The association between various risk factors such as history of cardiovascular disease, hypertension, diabetes mellitus, migraines, and stroke has been investigated. Multivariate regression analysis was implemented to estimate the odds ratio (OR) of each risk factor for stroke events.
Results: Findings showed that according to multivariate logistic regression, factors such as a history coronary heart disease (OR = 23.33, P = 0.002) and hypertension (OR = 6.9, P = 0.001), low high-density lipoprotein (HDL) (OR = 6.84, P < 0.001), history of coronary heart disease, and cerebrovascular disease in first degree relatives (OR = 4.18, P = 0.007), have been identified as a predictor of ischemic stroke.
Conclusion: Following this hospital-based study of Iranians, we demonstrated that among various risk factors, history of coronary heart disease, hypertension, as well as low HDL, and history of coronary heart disease and cerebrovascular disease in first degree relatives are the strongest independent predictors of stroke.


Stroke; Ischemic; Risk factors

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Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, et al. Grand challenges in chronic non-communicable diseases. Nature 2007; 450(7169): 494-6.

Upadhyay RP. An overview of the burden of non-communicable diseases in India. Iran J Public Health 2012; 41(3): 1-8.

Miranda JJ, Kinra S, Casas JP, Davey SG, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Trop Med Int Health 2008; 13(10): 1225-34.

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet 2014; 383(9913): 245-54.

Delbari A, Salman RR, Tabatabaei SS, Lokk J. A stroke study of an urban area of Iran: risk factors, length of stay, case fatality, and discharge destination. J Stroke Cerebrovasc Dis 2010; 19(2): 104-9.

Johnston SC, Mendis S, Mathers CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol 2009; 8(4): 345-54.

Wasay M, Kaul S, Menon B, Venketasubramanian N, Gunaratne P, Khalifa A, et al. Ischemic stroke in young Asian women: risk factors, subtypes and outcome. Cerebrovasc Dis 2010; 30(4): 418-22.

Lipska K, Sylaja PN, Sarma PS, Thankappan KR, Kutty VR, Vasan RS, et al. Risk factors for acute ischaemic stroke in young adults in South India. J Neurol Neurosurg Psychiatry 2007; 78(9): 959-63.

Tran J, Mirzaei M, Anderson L, Leeder SR. The epidemiology of stroke in the Middle East and North Africa. J Neurol Sci 2010; 295(1-2): 38-40.

Fahimfar N, Khalili D, Mohebi R, Azizi F, Hadaegh F. Risk factors for ischemic stroke; results from 9 years of follow-up in a population based cohort of Iran. BMC Neurol 2012; 12: 117.

Hosseini AA, Sobhani-Rad D, Ghandehari K, Benamer HT. Frequency and clinical patterns of stroke in Iran - Systematic and critical review. BMC Neurol 2010; 10: 72.

Borhani HA, Karimi AA, Amiri A, Ghaffarpasand F. Knowledge and attitude towards stroke risk factors, warning symptoms and treatment in an Iranian population. Med Princ Pract 2010; 19(6): 468-72.

World Health Organization. WHO STEPS stroke manual: The WHO STEPwise approach to stroke surveillance. Geneva, Switzerland: WHO; 2006.

Schneider AT, Pancioli AM, Khoury JC, Rademacher E, Tuchfarber A, Miller R, et al. Trends in community knowledge of the warning signs and risk factors for stroke. JAMA 2003; 289(3): 343-6.

Mirmiran P, Djazayery A, Hosseini Esfahani F, Mehrabi Y, Azizi F. Change in food patterns of Tehrani adults and its association with changes in their body weight and body mass index in District 13 of Tehran: Tehran Lipid and Glucose Study. Iran J Nutr Sci Food Technol 2008; 2(4): 67-80. [In Persian].

Bando K, Kobayashi J, Hirata M, Satoh T, Niwaya K, Tagusari O, et al. Early and late stroke after mitral valve replacement with a mechanical prosthesis: risk factor analysis of a 24-year experience. J Thorac Cardiovasc Surg 2003; 126(2): 358-64.

O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376(9735): 112-23.

Harirchian MH, Ghaffarpour M, Doratotaj D, Akhavirad MB. Stroke in young adults: a retrospective study of 68 cases. Acta Medica Iranica 2006; 44(2): 119-24.

Phillips MC, Leyden JM, Chong WK, Kleinig T, Czapran P, Lee A, et al. Ischaemic stroke among young people aged 15 to 50

years in Adelaide, South Australia. Med J Aust 2011; 195(10): 610-4.

Chang CL, Donaghy M, Poulter N. Migraine and stroke in young women: case-control study. The World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. BMJ 1999; 318(7175): 13-8.

Suzuki N. Migraine and stroke. Rinsho Shinkeigaku 2006; 46(11): 899-901. [In Japanese].

Tan KS, Tan CT, Churilov L, Mackay M, Donna GA. Ischaemic stroke in young adults: A comparative study between Malaysia and Australia. Neurology Asia 2010; 15(1): 1-9.

Osmond JM, Mintz JD, Dalton B, Stepp DW. Obesity increases blood pressure, cerebral vascular remodeling, and severity of stroke in the Zucker rat. Hypertension 2009; 53(2): 381-6.

Kannel WB, Cupples LA, Ramaswami R, Stokes J 3rdKreger BE, Higgins M. Regional obesity and risk of cardiovascular disease; the Framingham Study. J Clin Epidemiol 1991; 44(2): 183-90.

Katsiki N, Ntaios G, Vemmos K. Stroke, obesity and gender: a review of the literature. Maturitas 2011; 69(3): 239-43.

Lee TH, Hsu WC, Chen CJ, Chen ST. Etiologic study of young ischemic stroke in Taiwan. Stroke 2002; 33(8): 1950-5.

Jood K, Ladenvall C, Rosengren A, Blomstrand C, Jern C. Family history in ischemic stroke before 70 years of age: the Sahlgrenska Academy Study on Ischemic Stroke. Stroke 2005; 36(7): 1383-7.

Janssen AW, de Leeuw FE, Janssen MC. Risk factors for ischemic stroke and transient ischemic attack in patients under age 50. J Thromb Thrombolysis 2011; 31(1): 85-91.

Zhang YN, He L. Risk factors study of ischemic stroke in young adults in Southwest China. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43(4): 553-7. [In Chinese].


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