Unraveling the risk factors for spontaneous intracerebral hemorrhage among West Africans.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
10 03 2020
10 03 2020
Historique:
received:
09
03
2019
accepted:
26
09
2019
pubmed:
23
2
2020
medline:
9
7
2020
entrez:
21
2
2020
Statut:
ppublish
Résumé
To characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence and severity among West Africans. The Stroke Investigative Research and Educational Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Patients were adults ≥18 years old with CT-confirmed sICH with age-, sex-, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle, and psychosocial factors. Factors associated with sICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% confidence intervals (CIs) for factors. Of 2,944 adjudicated stroke cases, 854 were intracerebral hemorrhage (ICH). Mean age of patients with ICH was 54.7 ± 13.9 years, with a male preponderance (63.1%), and 77.3% were nonlobar. Etiologic subtypes of sICH included hypertension (80.9%), structural vascular anomalies (4.0%), cerebral amyloid angiopathy (0.7%), systemic illnesses (0.5%), medication-related (0.4%), and undetermined (13.7%). Eight factors independently associated with sICH occurrence by decreasing order of PAR with their adjusted OR (95% CI) were hypertension, 66.63 (20.78-213.72); dyslipidemia, 2.95 (1.84-4.74); meat consumption, 1.55 (1.01-2.38); family history of CVD, 2.22 (1.41-3.50); nonconsumption of green vegetables, 3.61 (2.07-6.31); diabetes mellitus, 2.11 (1.29-3.46); stress, 1.68 (1.03-2.77); and current tobacco use, 14.27 (2.09-97.47). Factors associated with severe sICH using an NIH Stroke Scale score >15 with adjusted OR (95% CI) were nonconsumption of leafy green vegetables, 2.03 (1.43-2.88); systolic blood pressure for each mm Hg rise, 1.01 (1.00-1.01); presence of midline shift, 1.54 (1.11-2.13); lobar ICH, 1.72 (1.16-2.55); and supratentorial bleeds, 2.17 (1.06-4.46). Population-level control of the dominant factors will substantially mitigate the burden of sICH in West Africa.
Identifiants
pubmed: 32075893
pii: WNL.0000000000009056
doi: 10.1212/WNL.0000000000009056
pmc: PMC7238923
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e998-e1012Subventions
Organisme : NHGRI NIH HHS
ID : U54 HG007479
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS107900
Pays : United States
Organisme : Department of Health
Pays : United Kingdom
Investigateurs
Sheila Adamu
(S)
Dominic Awuah
(D)
Raelle Saulson
(R)
Ojagbemi Akin
(O)
Lanre Olaniyan
(L)
Ezinne Uvere
(E)
Issa Kehinde
(I)
Francis Agyekum
(F)
Josephine Akpalu
(J)
Ayanfe Omololu
(A)
Folajimi Otubogun
(F)
Adeniji Olaleye
(A)
Amina Durodola
(A)
Taiwo Olunuga
(T)
Kazeem Akinwande
(K)
Omisore Adeleye
(O)
Philip Ibinaiye
(P)
Caroline Asaleye
(C)
Lucius Imoh
(L)
Tolulope Afolaranmi
(T)
Obiora Okeke
(O)
Andrew Bock-Oruma
(A)
Philip Adebayo
(P)
Ayotunde Bisi
(A)
Joseph Yaria
(J)
Chidi Joseph Odo
(CJ)
Ayobami Oguntoye
(A)
Paul Olowoyo
(P)
Taofeeq Sanni
(T)
Mayowa Aridegbe
(M)
Innocent Chukwuonye
(I)
Kelechi Umanruochi
(K)
Ugochukwu Onyeonoro
(U)
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 American Academy of Neurology.
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