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Excess body weight and incidence of stroke meta-analysis of prospective studies with 2 million participants

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Strazzullo, Pasquale, D'Elia, Lanfranco, Cairella, Giulia, Garbagnati, Francesca, Cappuccio, Francesco and Scalfi, Luca. (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 0039-2499

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Official URL: http://dx.doi.org/10.1161/STROKEAHA.109.576967

Abstract

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. (Stroke. 2010;41:e418-e426.)

Item Type:

Journal Article

Subjects:

R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine

Divisions:

Faculty of Medicine > Warwick Medical School

Journal or Publication Title:

Stroke

Publisher:

Lippincott Williams & Wilkins

ISSN:

0039-2499