Impact of preventable risk factors on stroke in the EPICOR study: does gender matter? in International journal of public health / Int J Public Health. 2017 Sep;62(7):775-786. doi: 10.1007/s00038-017-0993-2. Epub 2017 Jun 22.
2017
AOU Città della Salute di Torino
Tipo pubblicazione
Journal Article
Autori/Collaboratori (14)Vedi tutti...
Trajkova S
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO), Turin, Italy.
d'Errico A
Unit of Epidemiology, Regional Health Service, Grugliasco, Turin, Italy.
Ricceri F
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO), Turin, Italy.
et alii...
Abstract
OBJECTIVES: The effect of modifiable stroke risk factors in terms of prevented cases remains unclear due to sex-specific disease rate and risk factors prevalence. Our aim was to estimate their impact on stroke by gender through population-attributable fraction (PAF), preventive fraction (PF) and their combination in EPIC-Italian cohort. METHODS: 43,976 participants, age 34-75, and free of cardiovascular disease at baseline (1993-1998) were followed up for almost 11 years. Adjusted hazard ratios and PAF were estimated using Cox models. RESULTS: We identified 386 cases. In males, the burden for stroke was 17% (95% CI 4-28%) for smoking and 14% (95% CI 5-22%) for alcohol consumption. In females, hypertension was carrying the biggest burden with 18% (95% CI 9-26%) followed by smoking 15% (95% CI 7-22%). Their combination was 46% (95% CI 32-58%) in males and 48% (95% CI 35-59%) in females. PF for current smokers was gender unequal [males 21% (95% CI 15-27%) females 9% (95% CI 1-17%)]. CONCLUSIONS: Half of strokes are attributable to potentially modifiable factors. The proportion of prevented cases is gender unbalanced, encouraging sex-specific intervention.
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PMID : 28643029
DOI : 10.1007/s00038-017-0993-2
Keywords
Adult; Aged; Cohort Studies; Female; Humans; Italy/epidemiology; Male; Middle Aged; Risk Factors; Sex Distribution; Stroke/epidemiology; Cohort study; Gender medicine; Population-attributable fraction; Preventive fraction; Risk factors; Stroke;