Wednesday, October 6, 2010

Rising Stroke Rates Among Middle-Aged Women in the United States

Peningkatan prevalensi obesitas dan sindroma metabolik menyebabkan peningkatan prevalensi stroke pada wanita

Stroke. 2010;41:1371

Weight of the Obesity Epidemic
Rising Stroke Rates Among Middle-Aged Women in the United States
Amytis Towfighi, MD; Ling Zheng, PhD Bruce Ovbiagele, MD

From the Department of Neurology (A.T., L.Z.), University of Southern California, Los Angeles, Calif; and the Department of Neurology (B.O.), University of California at Los Angeles, Los Angeles, Calif.
Background and Purpose— Recent US nationally representative data revealed that among individuals aged 45 to 54 years, women's stroke prevalence was double that of men's. The purpose of this study was to determine if the sex disparity existed previously.
Methods— We assessed sex-specific stroke and vascular risk factor prevalence among individuals aged 35 to 64 years who participated in the National Health and Nutrition Examination Surveys (NHANES), a cross-sectional, nationally representative survey conducted in 2 waves: 1988 to 1994 (n=7234) and 1999 to 2004 (n=6499).
Results— Women aged 35 to 54 years who participated in NHANES from 1999 to 2004 were 3 times more likely to have experienced a stroke compared with similarly aged women in NHANES 1988 to 1994 (1.8% versus 0.6%,P=0.003), but stroke prevalence among men did not change (0.9% versus 1.0%, nonsignificant). Among women, the prevalence of obesity (15.2% versus 17.9%, P=0.08), morbid obesity (12.8% versus 17.5%, P=0.003), abdominal obesity (47.4% versus 58.9%, P<0.0001), hypertriglyceridemia (22.91% versus 26.78%, P=0.035), and hypertension (33.04% versus 37.43%, P=0.03) was lower in NHANES 1988 to 1994 compared with the morerecent NHANES wave. Higher waist circumference was the only independent stroke risk factor for women aged 35 to 54 years in NHANES 1999 to 2004 (OR per 15-cm increase in waist circumference=1.02, 95% CI 1.00 to 1.04).
Conclusions— Stroke prevalence among women aged 35 to 54 years has tripled over the past 2 decades, at the same time remaining stable among men. Prevalence of obesity and 3 metabolic syndrome components increased; they may be key factors in the increase in women's stroke prevalence.

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