title: A comparative analysis of risk factors and stroke risk for Asian and non-Asian men: the Asia Pacific cohort studies collaboration.
abstract: BACKGROUND
  The risk of stroke is high in men among both Asian and non-Asian populations, despite differences in risk factor profiles; whether risk factors act similarly in these populations is unknown.
  
  
  OBJECTIVE
  To study the associations between five major risk factors and stroke risk, comparing Asian with non-Asian men.
  
  
  METHODS
  We obtained data from the Asia Pacific Cohort Studies Collaboration, a pooled analysis of individual participant data from 44 studies involving 386 411 men with 9·4 years follow-up. Using cohorts from Asia and Australia/New Zealand Cox models were fitted to estimate risk factor associations for ischemic and haemorrhagic stroke.
  
  
  RESULTS
  We identified significant, positive associations between all five risk factors and risk of ischemic stroke. The associations between body mass index, smoking, and diabetes with ischemic stroke were comparable for men from Asia and Australia/New Zealand. The association between systolic blood pressure and ischemic stroke was stronger for Asian than Australia/New Zealand cohorts, whereas the reverse was true for total cholesterol. For haemorrhagic stroke, only systolic blood pressure and smoking were associated with increased risk, although the relationship with systolic blood pressure was significantly stronger for men from Asia than Australia/New Zealand (P interaction  = 0·03), whereas the reverse was true for smoking (P interaction  = 0·001). There was an inverse trend of total cholesterol with haemorrhagic stroke, significant only for Asian men.
  
  
  CONCLUSIONS
  Men from the Asia-Pacific region share common risk factors for stroke. Strategies aimed at lowering population levels of systolic blood pressure, total cholesterol, body mass index, smoking, and diabetes are likely to be beneficial in reducing stroke risk, particularly for ischemic stroke, across the region.
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Karice K
authors.initials: KK
authors.lastname: Hyun
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Huxley
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
authors.forename: Xianghua
authors.initials: X
authors.lastname: Fang
authors.forename: Sanne A E
authors.initials: SA
authors.lastname: Peters
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Jee
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Federica
authors.initials: F
authors.lastname: Barzi
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D044465:White People
chemical_list: D002784:Cholesterol
keywords: Asia; epidemiology; haemorrhagic stroke; ischemic stroke; meta-analysis; non-Asia; risk factors