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Impact of preventable risk factors on stroke in the EPICOR study: does gender matter?

Author

Listed:
  • Slavica Trajkova

    (University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO))

  • Angelo d’Errico

    (Regional Health Service)

  • Fulvio Ricceri

    (University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO)
    Regional Health Service)

  • Francesca Fasanelli

    (University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO))

  • Valeria Pala

    (Fondazione IRCCS Istituto Nazionale dei Tumori)

  • Claudia Agnoli

    (Fondazione IRCCS Istituto Nazionale dei Tumori)

  • Rosario Tumino

    (Cancer Registry, Department of Prevention)

  • Graziella Frasca

    (Cancer Registry, Department of Prevention)

  • Giovanna Masala

    (Cancer Risk Factors and Lifestyle Epidemiology Unit Cancer Research and Prevention Institute-ISPO)

  • Calogero Saieva

    (Cancer Risk Factors and Lifestyle Epidemiology Unit Cancer Research and Prevention Institute-ISPO)

  • Paolo Chiodini

    (Second University of Naples)

  • Amalia Mattiello

    (Federico II University)

  • Carlotta Sacerdote

    (University of Turin and Città della Salute e della Scienza University-Hospital Center for Cancer Prevention (CPO))

  • Salvatore Panico

    (Federico II University)

Abstract

Objectives The effect of modifiable stroke risk factors in terms of prevented cases remains unclear due to sex-specific disease rate and risk factors prevalence. Our aim was to estimate their impact on stroke by gender through population-attributable fraction (PAF), preventive fraction (PF) and their combination in EPIC-Italian cohort. Methods 43,976 participants, age 34–75, and free of cardiovascular disease at baseline (1993–1998) were followed up for almost 11 years. Adjusted hazard ratios and PAF were estimated using Cox models. Results We identified 386 cases. In males, the burden for stroke was 17% (95% CI 4–28%) for smoking and 14% (95% CI 5–22%) for alcohol consumption. In females, hypertension was carrying the biggest burden with 18% (95% CI 9–26%) followed by smoking 15% (95% CI 7–22%). Their combination was 46% (95% CI 32–58%) in males and 48% (95% CI 35–59%) in females. PF for current smokers was gender unequal [males 21% (95% CI 15–27%) females 9% (95% CI 1–17%)]. Conclusions Half of strokes are attributable to potentially modifiable factors. The proportion of prevented cases is gender unbalanced, encouraging sex-specific intervention.

Suggested Citation

  • Slavica Trajkova & Angelo d’Errico & Fulvio Ricceri & Francesca Fasanelli & Valeria Pala & Claudia Agnoli & Rosario Tumino & Graziella Frasca & Giovanna Masala & Calogero Saieva & Paolo Chiodini & Ama, 2017. "Impact of preventable risk factors on stroke in the EPICOR study: does gender matter?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(7), pages 775-786, September.
    • Handle: RePEc:spr:ijphth:v:62:y:2017:i:7:d:10.1007_s00038-017-0993-2
    DOI: 10.1007/s00038-017-0993-2
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    References listed on IDEAS

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    1. Roger Newson, 2012. "Scenario comparisons: How much good can we do?," United Kingdom Stata Users' Group Meetings 2012 01, Stata Users Group.
    2. Roger B. Newson, 2013. "Attributable and unattributable risks and fractions and other scenario comparisons," Stata Journal, StataCorp LP, vol. 13(4), pages 672-698, December.
    3. Mostofsky, E. & Mukamal, K.J. & Giovannucci, E.L. & Stampfer, M.J. & Rimm, E.B., 2016. "Key findings on alcohol consumption and a variety of health outcomes from the nurses' health study," American Journal of Public Health, American Public Health Association, vol. 106(9), pages 1586-1591.
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    Cited by:

    1. Carolin Malsch & Thomas Liman & Silke Wiedmann & Bob Siegerink & Marios K Georgakis & Steffen Tiedt & Matthias Endres & Peter U Heuschmann, 2018. "Outcome after stroke attributable to baseline factors—The PROSpective Cohort with Incident Stroke (PROSCIS)," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-14, September.

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