Prevalence of Cardiovascular Risk Factors in Stroke on the Rise

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While the increase in cardiovascular risk factors is at least partially due to the obesity epidemic, the researchers believe the increase is multifactorial.

The prevalence of cardiovascular risk factors, such as diabetes, hypertension, dyslipidemia, and smoking, substantially increased in patients with acute ischemic stroke (AIS) between 2004 and 2014, according to a study published in Neurology.

Diabetes (34%), dyslipidemia (47%), hypertension (79%), and smoking (15%) were the most prevalent risk factors in the majority of this AIS patient population, with most patients having ≥1 risk factors for cardiovascular disease.

Hypertension was the most prevalent cardiovascular risk factor across the study period (79%), followed by dyslipidemia (47%), diabetes (34%), smoking (15%), and drug abuse (2%). The prevalence rates of coronary artery disease, carotid stenosis, and chronic renal failure were 27%, 13%, and 12%, respectively. The researchers found that older AIS patients (60 to 79) had more prevalent risk factors than younger AIS patients (18 to 39) overall (82% vs 44%, respectively).

In addition, Hispanic subjects had a greater prevalence of diabetes than whites (49% vs 30%, respectively), and men abused drugs approximately twice as much as women (3% vs 1.4%, respectively). The prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse rose annually by 1.4%, 2%, 7%, 5%, and 7%, respectively.

For this study, diagnoses were based on ICD-9 codes, which may present the potential of diagnostic errors. The modification of risk factor definitions over the past 10 years, such as the 2009 changes, which suggest including hemoglobin A1c >6.5% for defining diabetes, may also have had an impact on the researchers’ trend analysis.

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Although the “obesity epidemic and persistent concerns about physical inactivity” may be partially responsible, the investigators suggest the increasing prevalence of cardiovascular-related risk factors in patients with AIS is multifactorial.


Otite FO, Liaw N, Khandelwal P, et al. Increasing prevalence of vascular risk factors in patients with stroke: A call to action [published online October 11, 2017]. Neurology. doi:10.1212/WNL.0000000000004617