Impact of obesity and the metabolic syndrome on risk factors in African American stroke survivors: a report from the AAASPS.
BACKGROUND
The rates of obesity and the metabolic syndrome and the impact on traditional vascular risk factors in African American stroke survivors are unknown.


OBJECTIVE
To describe the relationships between body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and hypertension, dyslipidemia, and diabetes mellitus.


METHODS
We classified 1711 subjects as underweight (BMI, <18.5), normal (BMI, 18.5-24.9), overweight (BMI, 25.0-29.9), or obesity class 1 (BMI, 30.0-34.9), 2 (BMI, 35.0-39.9), or 3 (BMI, >40.0). We compared the proportions with hypertension, dyslipidemia, and diabetes mellitus and control of these factors by clinical history and results of physical examination and laboratory analysis across BMI groups.


METHODS
Multicentered clinical trial.


METHODS
African American subjects with previous ischemic stroke.


METHODS
Rates of obesity and the metabolic syndrome, odds ratios (ORs) of associated vascular risk factors at baseline, and relationship to longitudinal risk factor control.


RESULTS
Overall, 76% were overweight or obese (70% of men and 81% of women). Hypertension, dyslipidemia, and diabetes mellitus were all present in 43.3% of men and 29.1% of women with obesity class 3. The ORs for having the metabolic syndrome were 2.14 (95% confidence interval [CI], 1.52-3.01) for class 1, 1.92 (95% CI, 1.26-2.91) for class 2, and 1.98 (95% CI, 1.27-3.09) for class 3 obesity. In addition, increasing BMI was negatively associated with systolic (P<.001) and diastolic (P<.001) blood pressure and glycemic control (P<.001).


CONCLUSIONS
Our analysis of the data from the African American Antiplatelet Stroke Prevention Study supports the association of increasing risk factor profiles with increasing weight in African American stroke survivors.
Ruland
Sean
S
Department of Neurology and Rehabilitation, University of Illinois at Chicago, 60612, USA. sruland@uic.edu
Hung
Elena
E
Richardson
Dejuran
D
Misra
Subhasree
S
Gorelick
Philip B
PB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D015992:Body Mass Index; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D001741:Black or African American