Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study

Bernadette Boden-Albala, Ralph L. Sacco, Hye Sueng Lee, Cairistine Grahame-Clarke, Tanja Rundek, Mitchell V. Elkind, Clinton Wright, Elsa Grace V Giardina, Marco R. Ditullio, Shunichi Homma, Myunghee C. Paik

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE - More than 47 million individuals in the United States meet the criteria for the metabolic syndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized. METHODS - As part of the Northern Manhattan Study, 3298 stroke-free community residents were prospectively followed up for a mean of 6.4 years. The metabolic syndrome was defined according to guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% CIs for ischemic stroke and vascular events (ischemic stroke, myocardial infarction, or vascular death). The etiologic fraction estimates the proportion of events attributable to the metabolic syndrome. RESULTS - More than 44% of the cohort had the metabolic syndrome (48% of women vs 38% of men, P<0.0001), which was more prevalent among Hispanics (50%) than whites (39%) or blacks (37%). The metabolic syndrome was associated with increased risk of stroke (HR=1.5; 95% CI, 1.1 to 2.2) and vascular events (HR=1.6; 95% CI, 1.3 to 2.0) after adjustment for sociodemographic and risk factors. The effect of the metabolic syndrome on stroke risk was greater among women (HR=2.0; 95% CI, 1.3 to 3.1) than men (HR=1.1; 95% CI, 0.6 to 1.9) and among Hispanics (HR=2.0; 95% CI, 1.2 to 3.4) compared with blacks and whites. The etiologic fraction estimates suggest that elimination of the metabolic syndrome would result in a 19% reduction in overall stroke, a 30% reduction of stroke in women; and a 35% reduction of stroke among Hispanics. CONCLUSIONS - The metabolic syndrome is an important risk factor for ischemic stroke, with differential effects by sex and race/ethnicity.

Original languageEnglish (US)
Pages (from-to)30-35
Number of pages6
JournalStroke
Volume39
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Stroke
Hispanic Americans
Blood Vessels
Proportional Hazards Models
Myocardial Infarction
Cholesterol
Guidelines
Education
Population

Keywords

  • Epidemiology
  • Ischemic stroke
  • Metabolic syndrome
  • Race/ethnicity
  • Risk factors
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)
  • Medicine(all)

Cite this

Boden-Albala, B., Sacco, R. L., Lee, H. S., Grahame-Clarke, C., Rundek, T., Elkind, M. V., ... Paik, M. C. (2008). Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study. Stroke, 39(1), 30-35. https://doi.org/10.1161/STROKEAHA.107.496588

Metabolic syndrome and ischemic stroke risk : Northern Manhattan Study. / Boden-Albala, Bernadette; Sacco, Ralph L.; Lee, Hye Sueng; Grahame-Clarke, Cairistine; Rundek, Tanja; Elkind, Mitchell V.; Wright, Clinton; Giardina, Elsa Grace V; Ditullio, Marco R.; Homma, Shunichi; Paik, Myunghee C.

In: Stroke, Vol. 39, No. 1, 01.2008, p. 30-35.

Research output: Contribution to journalArticle

Boden-Albala, B, Sacco, RL, Lee, HS, Grahame-Clarke, C, Rundek, T, Elkind, MV, Wright, C, Giardina, EGV, Ditullio, MR, Homma, S & Paik, MC 2008, 'Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study', Stroke, vol. 39, no. 1, pp. 30-35. https://doi.org/10.1161/STROKEAHA.107.496588
Boden-Albala B, Sacco RL, Lee HS, Grahame-Clarke C, Rundek T, Elkind MV et al. Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study. Stroke. 2008 Jan;39(1):30-35. https://doi.org/10.1161/STROKEAHA.107.496588
Boden-Albala, Bernadette ; Sacco, Ralph L. ; Lee, Hye Sueng ; Grahame-Clarke, Cairistine ; Rundek, Tanja ; Elkind, Mitchell V. ; Wright, Clinton ; Giardina, Elsa Grace V ; Ditullio, Marco R. ; Homma, Shunichi ; Paik, Myunghee C. / Metabolic syndrome and ischemic stroke risk : Northern Manhattan Study. In: Stroke. 2008 ; Vol. 39, No. 1. pp. 30-35.
@article{cb093246542d4f6d9c8e9dbb8f3d1838,
title = "Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study",
abstract = "BACKGROUND AND PURPOSE - More than 47 million individuals in the United States meet the criteria for the metabolic syndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized. METHODS - As part of the Northern Manhattan Study, 3298 stroke-free community residents were prospectively followed up for a mean of 6.4 years. The metabolic syndrome was defined according to guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95{\%} CIs for ischemic stroke and vascular events (ischemic stroke, myocardial infarction, or vascular death). The etiologic fraction estimates the proportion of events attributable to the metabolic syndrome. RESULTS - More than 44{\%} of the cohort had the metabolic syndrome (48{\%} of women vs 38{\%} of men, P<0.0001), which was more prevalent among Hispanics (50{\%}) than whites (39{\%}) or blacks (37{\%}). The metabolic syndrome was associated with increased risk of stroke (HR=1.5; 95{\%} CI, 1.1 to 2.2) and vascular events (HR=1.6; 95{\%} CI, 1.3 to 2.0) after adjustment for sociodemographic and risk factors. The effect of the metabolic syndrome on stroke risk was greater among women (HR=2.0; 95{\%} CI, 1.3 to 3.1) than men (HR=1.1; 95{\%} CI, 0.6 to 1.9) and among Hispanics (HR=2.0; 95{\%} CI, 1.2 to 3.4) compared with blacks and whites. The etiologic fraction estimates suggest that elimination of the metabolic syndrome would result in a 19{\%} reduction in overall stroke, a 30{\%} reduction of stroke in women; and a 35{\%} reduction of stroke among Hispanics. CONCLUSIONS - The metabolic syndrome is an important risk factor for ischemic stroke, with differential effects by sex and race/ethnicity.",
keywords = "Epidemiology, Ischemic stroke, Metabolic syndrome, Race/ethnicity, Risk factors, Sex",
author = "Bernadette Boden-Albala and Sacco, {Ralph L.} and Lee, {Hye Sueng} and Cairistine Grahame-Clarke and Tanja Rundek and Elkind, {Mitchell V.} and Clinton Wright and Giardina, {Elsa Grace V} and Ditullio, {Marco R.} and Shunichi Homma and Paik, {Myunghee C.}",
year = "2008",
month = "1",
doi = "10.1161/STROKEAHA.107.496588",
language = "English (US)",
volume = "39",
pages = "30--35",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Metabolic syndrome and ischemic stroke risk

T2 - Northern Manhattan Study

AU - Boden-Albala, Bernadette

AU - Sacco, Ralph L.

AU - Lee, Hye Sueng

AU - Grahame-Clarke, Cairistine

AU - Rundek, Tanja

AU - Elkind, Mitchell V.

AU - Wright, Clinton

AU - Giardina, Elsa Grace V

AU - Ditullio, Marco R.

AU - Homma, Shunichi

AU - Paik, Myunghee C.

PY - 2008/1

Y1 - 2008/1

N2 - BACKGROUND AND PURPOSE - More than 47 million individuals in the United States meet the criteria for the metabolic syndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized. METHODS - As part of the Northern Manhattan Study, 3298 stroke-free community residents were prospectively followed up for a mean of 6.4 years. The metabolic syndrome was defined according to guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% CIs for ischemic stroke and vascular events (ischemic stroke, myocardial infarction, or vascular death). The etiologic fraction estimates the proportion of events attributable to the metabolic syndrome. RESULTS - More than 44% of the cohort had the metabolic syndrome (48% of women vs 38% of men, P<0.0001), which was more prevalent among Hispanics (50%) than whites (39%) or blacks (37%). The metabolic syndrome was associated with increased risk of stroke (HR=1.5; 95% CI, 1.1 to 2.2) and vascular events (HR=1.6; 95% CI, 1.3 to 2.0) after adjustment for sociodemographic and risk factors. The effect of the metabolic syndrome on stroke risk was greater among women (HR=2.0; 95% CI, 1.3 to 3.1) than men (HR=1.1; 95% CI, 0.6 to 1.9) and among Hispanics (HR=2.0; 95% CI, 1.2 to 3.4) compared with blacks and whites. The etiologic fraction estimates suggest that elimination of the metabolic syndrome would result in a 19% reduction in overall stroke, a 30% reduction of stroke in women; and a 35% reduction of stroke among Hispanics. CONCLUSIONS - The metabolic syndrome is an important risk factor for ischemic stroke, with differential effects by sex and race/ethnicity.

AB - BACKGROUND AND PURPOSE - More than 47 million individuals in the United States meet the criteria for the metabolic syndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized. METHODS - As part of the Northern Manhattan Study, 3298 stroke-free community residents were prospectively followed up for a mean of 6.4 years. The metabolic syndrome was defined according to guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% CIs for ischemic stroke and vascular events (ischemic stroke, myocardial infarction, or vascular death). The etiologic fraction estimates the proportion of events attributable to the metabolic syndrome. RESULTS - More than 44% of the cohort had the metabolic syndrome (48% of women vs 38% of men, P<0.0001), which was more prevalent among Hispanics (50%) than whites (39%) or blacks (37%). The metabolic syndrome was associated with increased risk of stroke (HR=1.5; 95% CI, 1.1 to 2.2) and vascular events (HR=1.6; 95% CI, 1.3 to 2.0) after adjustment for sociodemographic and risk factors. The effect of the metabolic syndrome on stroke risk was greater among women (HR=2.0; 95% CI, 1.3 to 3.1) than men (HR=1.1; 95% CI, 0.6 to 1.9) and among Hispanics (HR=2.0; 95% CI, 1.2 to 3.4) compared with blacks and whites. The etiologic fraction estimates suggest that elimination of the metabolic syndrome would result in a 19% reduction in overall stroke, a 30% reduction of stroke in women; and a 35% reduction of stroke among Hispanics. CONCLUSIONS - The metabolic syndrome is an important risk factor for ischemic stroke, with differential effects by sex and race/ethnicity.

KW - Epidemiology

KW - Ischemic stroke

KW - Metabolic syndrome

KW - Race/ethnicity

KW - Risk factors

KW - Sex

UR - http://www.scopus.com/inward/record.url?scp=38149012414&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38149012414&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.107.496588

DO - 10.1161/STROKEAHA.107.496588

M3 - Article

VL - 39

SP - 30

EP - 35

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -