title: Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults.
abstract: BACKGROUND
  Little is known about the risk factors for cervical artery dissection (CEAD), a major cause of ischemic stroke (IS) in young adults. Hypertension, diabetes mellitus, smoking, hypercholesterolemia, and obesity are important risk factors for IS. However, their specific role in CEAD is poorly investigated. Our aim was to compare the prevalence of vascular risk factors in CEAD patients versus referents and patients who suffered an IS of a cause other than CEAD (non-CEAD IS) in the multicenter Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study.
  
  
  RESULTS
  The study sample comprised 690 CEAD patients (mean age, 44.2 ± 9.9 years; 43.9% women), 556 patients with a non-CEAD IS (44.7 ± 10.5 years; 39.9% women), and 1170 referents (45.9 ± 8.1 years; 44.1% women). We compared the prevalence of hypertension, diabetes mellitus, hypercholesterolemia, smoking, and obesity (body mass index ≥ 30 kg/m²) or overweightness (body mass index ≥ 25 kg/m² and <30 kg/m²) between the 3 groups using a multinomial logistic regression adjusted for country of inclusion, age, and gender. Compared with referents, CEAD patients had a lower prevalence of hypercholesterolemia (odds ratio 0.55; 95% confidence interval, 0.42 to 0.71; P<0.0001), obesity (odds ratio 0.37; 95% confidence interval, 0.26 to 0.52; P<0.0001), and overweightness (odds ratio 0.70; 95% confidence interval, 0.57 to 0.88; P=0.002) but were more frequently hypertensive (odds ratio 1.67; 95% confidence interval, 1.32 to 2.1; P<0.0001). All vascular risk factors were less frequent in CEAD patients compared with young patients with a non-CEAD IS. The latter were more frequently hypertensive, diabetic, and current smokers compared with referents.
  
  
  CONCLUSIONS
  These results, from the largest series to date, suggest that hypertension, although less prevalent than in patients with a non-CEAD IS, could be a risk factor of CEAD, whereas hypercholesterolemia, obesity, and overweightness are inversely associated with CEAD.
authors: Department of Epidemiology and Public Health, Inserm U744, Institut Pasteur de Lille, 1, Rue du Professeur Calmette, BP245, 59019 Lille Cedex, France. stephdebette@wanadoo.fr
authors: Stéphanie
authors: S
authors: Debette
authors: Tiina
authors: T
authors: Metso
authors: Alessandro
authors: A
authors: Pezzini
authors: Shérine
authors: S
authors: Abboud
authors: Antti
authors: A
authors: Metso
authors: Didier
authors: D
authors: Leys
authors: Anna
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authors: Bersano
authors: Fabien
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authors: Louillet
authors: Valeria
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authors: Caso
authors: Chantal
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authors: Lamy
authors: Elisabeth
authors: E
authors: Medeiros
authors: Yves
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authors: Samson
authors: Caspar
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authors: Grond-Ginsbach
authors: Stefan T
authors: ST
authors: Engelter
authors: Vincent
authors: V
authors: Thijs
authors: Simone
authors: S
authors: Beretta
authors: Yannick
authors: Y
authors: Béjot
authors: Maria
authors: M
authors: Sessa
authors: Maria
authors: M
authors: Lorenza Muiesan
authors: Philippe
authors: P
authors: Amouyel
authors: Maurizio
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authors: Castellano
authors: Dominique
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authors: Arveiler
authors: Turgut
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authors: Tatlisumak
authors: Jean
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authors: Dallongeville
mesh_terms: D000328:Adult; D020759:Anterior Spinal Artery Syndrome / Q000150:complications* / Q000453:epidemiology; D015897:Comorbidity; D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*