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Cerebrovascular disease and risk of stroke

Submitted by Dr. Yasser Mokhtar, MD. Dept. of internal medicine. School of medicine, University of South Dakota.

 

Stroke is a loss of cerebral function with symptoms lasting >24 hrs or death due to vascular disease

 
 

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Risk factors for stroke

Non-modifiable risk factors

Although cerebrovascular disorders may occur at any age, at any time, in either sex and in all races, each of these non-modifiable factors affect the incidence of stroke.

Age

This is the strongest risk factor for cerebral infarction, primary intracerebral hemorrhage (PICH) and subarachnoid hemorrhage (SAH) (Bamford et al., 1990) and almost certainly for subtypes of cerebral infarction as well (e.g. lacunar infarction) (Bamford et al., 1987) and for TIA (Dennis et al., 1989).

Stroke incidence rises exponentially with age, with most strokes occuring in persons older than sixty five years. Stroke is less common before the age of forty. It was found that the risk of stroke in people aged 75-84 is 14.3 per thousand per annum which is 25 times that in people aged 45-54 years with incidence of stroke 0.57 per thousand per annum (Bamford et al., 1988).

Sex

There is a small male excess of strokes, most prominent in middle age and disappearing in the very elderly and probably absent in the young (Haberman et al., 1981). A similar pattern is found for transient ischemic attacks (Dennis et al., 1989).

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