Risk Factors for Stroke: A Global Study

Bruce Soloway, MD


Journal Watch 

In This Article

Abstract and Introduction


Nine modifiable factors account for 90% of stroke incidence worldwide.


Studies of modifiable risk factors for stroke have been conducted largely in developed countries. Few data have been collected in the developing world, where 85% of stroke mortality occurs.

Replicating in part the methodology of the 2004 INTERHEART study of risk factors for first myocardial infarction (JW Gen Med Oct 5 2004), researchers recruited 3000 patients with recent first strokes in 22 countries on 6 continents; both developing and developed countries were represented. Each case patient was matched by age and sex with a control patient from the same community who did not have a history of stroke. Virtually all case patients received neuroimaging to determine stroke type (78% ischemic; 22% hemorrhagic).

As in the INTERHEART study, a small set of modifiable risk factors was identified. In this case, nine factors — hypertension, smoking, high waist-to-hip ratio, unhealthy diet, lack of regular exercise, diabetes, moderate or high alcohol intake, stress or depression, and high ratio of apoB to apoA1 lipoprotein — accounted for 90% of the worldwide risk for stroke. Contributions of various risk factors were similar across geographic regions. Hypertension alone accounted for 52% of risk for any stroke and 74% of risk for hemorrhagic stroke. Unlike waist-to-hip ratio, body-mass index was not associated with stroke risk.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: