title: Risk factors for ischemic stroke and its subtypes in Chinese vs. Caucasians: Systematic review and meta-analysis.
abstract: BACKGROUND
  Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians.
  
  
  OBJECTIVE
  To understand this better, we aimed to evaluate the differences in prevalence of risk factors in ischemic stroke and their distributions among ischemic stroke subtypes in Chinese vs. Caucasians.
  
  
  RESULTS
  We systematically sought studies conducted since 1990 with data on frequency of risk factors among ischemic stroke subtypes in Chinese or Caucasians. For each risk factor, we calculated study-specific and random effects pooled estimates in Chinese and Caucasians separately for: prevalence among ischemic stroke; odds ratios, comparing prevalence for each ischemic stroke subtype vs. all others. We included seven studies among 16,199 Chinese, and eleven among 16,189 Caucasian ischemic stroke patients. Risk factors studied were hypertension, diabetes, atrial fibrillation, ischemic heart disease, hypercholesterolemia, smoking and alcohol. Chinese ischemic stroke patients had younger onset of stroke than Caucasians, similar prevalence of hypertension, diabetes, smoking and alcohol, and significantly lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia. Risk factor associations with ischemic stroke subtypes were mostly similar among Chinese and Caucasian ischemic stroke patients. Compared with all other ischemic subtypes, diabetes was more common in large artery stroke, atrial fibrillation and ischemic heart disease in cardioembolic stroke, and hypertension and diabetes in lacunar stroke.
  
  
  CONCLUSIONS
  Our study showed a lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia in Chinese, and mostly similar risk factor associations in Chinese and Caucasian ischemic stroke patients. Further analyses of individual patient data to allow adjustment for confounders are needed to confirm and extend these findings.
authors.affiliation: Department of Neurology, Cardinal Tien Hospital, Taiwan.|School of Medicine, Fu Jen Catholic University, Taiwan.|Division of Clinical Neurosicences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Chung-Fen
authors.initials: CF
authors.lastname: Tsai
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Niall
authors.initials: N
authors.lastname: Anderson
authors.affiliation: Division of Clinical Neurosicences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Brenda
authors.initials: B
authors.lastname: Thomas
authors.affiliation: Division of Clinical Neurosicences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.|Institute of Genetics and Molecular Medicine (C.L.M.S), University of Edinburgh, Edinburgh, UK.
authors.forename: Cathie L M
authors.initials: CL
authors.lastname: Sudlow
mesh_terms: D044466:Asian People; D002545:Brain Ischemia / Q000208:ethnology*; D002681:China; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology*; D044465:White People
keywords: Chinese; Whites; ischemic stroke; risk factor; subtype