Excess body weight and incidence of stroke : meta-analysis of prospective studies with 2 million participants
Strazzullo, P., D'Elia, L., Cairella, G., Garbagnati, F., Cappuccio, Francesco P. and Scalfi, L.. (2010) Excess body weight and incidence of stroke : meta-analysis of prospective studies with 2 million participants. Stroke, Vol.41 (No.5). e418-e426. ISSN 0039-2499Full text not available from this repository.
Official URL: http://dx.doi.org/10.1161/STROKEAHA.109.576967
Background and Purpose— A systematic review of the prospective studies addressing the relationship of overweight and obesity to major stroke subtypes is lacking. We evaluated the occurrence of a graded association between overweight, obesity, and incidence of ischemic and hemorrhagic stroke by a meta-analysis of cohort studies.
Methods— A search of online databases and relevant reviews was performed. Inclusion criteria were original article in English, prospective study design, follow-up ≥4 years, indication of number of subjects exposed, and number of events across body mass index categories. Crude unadjusted relative risk (RR) and 95% CI were calculated for each study for overweight or obese compared with normal-weight categories. Log-transformed values and SE were used to calculate the pooled RR with random effects models; publication bias was checked. Additional analyses were performed using the multivariate estimates of risk reported in the individual studies.
Results— Twenty-five studies were included, with 2 274 961 participants and 30 757 events. RR for ischemic stroke was 1.22 (95% CI, 1.05–1.41) for overweight and 1.64 (95% CI, 1.36–1.99) for obesity, whereas RR for hemorrhagic stroke was 1.01 (95% CI, 0.88–1.17) and 1.24 (95% CI, 0.99–1.54), respectively. Subgroup and meta-regression analyses ruled out gender, population average age, body mass index and blood pressure, year of recruitment, year of study publication, and length of follow-up as significant sources of heterogeneity. The additional analyses relying on the published multivariate estimates of risk provided qualitatively similar results.
Conclusions— Overweight and obesity are associated with progressively increasing risk of ischemic stroke, at least in part, independently from age, lifestyle, and other cardiovascular risk factors.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)|
|Divisions:||Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health
Faculty of Medicine > Warwick Medical School
|Journal or Publication Title:||Stroke|
|Publisher:||Lippincott Williams & Wilkins|
|Official Date:||May 2010|
|Access rights to Published version:||Restricted or Subscription Access|
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