title: Which risk factors are more associated with ischemic rather than hemorrhagic stroke in black Africans?
abstract: OBJECTIVE
  To comprehensively examine the relationship of vascular risk factors to stroke type in native black Africans.
  
  
  METHODS
  We explored 34 candidate demographic, clinical, and laboratory variables in 282 consecutive adult stroke patients with brain imaging.
  
  
  RESULTS
  Ischemic stroke (IS) was found in 61.7% (174). Gender, alcohol, cigarette, homocysteine, C-reactive peptide, anthropometry, and carotid parameters were not significantly associated with stroke type (p>0.05). Patients with IS had relatively lower BP, were significantly older, and more frequently had diabetes mellitus, cardiac disease, or previous transient ischemic attack than patients with hemorrhagic stroke (HS). However, in multivariate regression model predicting 69% of stroke type correctly, age≥62 years (OR: 4.0, 95% CI: 2.0-7.9), previous TIA (OR: 4.3, 95% CI: 1.2-15.7) and systolic BP≥140 mmHg (OR: 0.4, 95% CI: 0.2-0.9) were the only independent significant predictors of IS.
  
  
  CONCLUSIONS
  With increasing proportion of the population over 61 years and better BP control, the proportion of IS is expected to rise in black African countries currently undergoing epidemiological transition (changing lifestyle/disease pattern). Therefore, relevant components of the stroke intervention quadrangle (stroke surveillance, acute care, preventive and rehabilitation services) should be tailored toward this need.
authors.affiliation: Department of Medicine, University College Hospital, Ibadan, 200001 Oyo State, Nigeria; College of Medicine, University of Ibadan. Nigeria. Electronic address: mayowaowolabi@yahoo.com.
authors.forename: Mayowa O
authors.initials: MO
authors.lastname: Owolabi
authors.forename: Atinuke M
authors.initials: AM
authors.lastname: Agunloye
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D015415:Biomarkers / Q000032:analysis; D044383:Black People; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology*; D002536:Cerebral Arteries / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D018401:Sample Size; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D015415:Biomarkers; D008055:Lipids
keywords: Black Africans; Hemorrhagic stroke; Ischemic stroke; Risk factors; Stroke quadrangle; Stroke type