Advances in Population-Based Studies

Abstract

In 2009, population-based studies have continued to generate many new results about stroke occurrence and interesting hypotheses about the relation between risk factors and stroke occurrence. High levels of C-reactive protein have been associated with the risk of myocardial infarction, whereas the association with stroke remains controversial.1 The association between high-sensitivity C-reactive protein (hsCRP)and stroke was examined in the multiethnic, stroke-free, community-based cohort study in Northern Manhattan.2 hsCRP measurements were available for 2240 subjects age 40 years and older. Compared with subjects whose hsCRP values were 3 mg/L were at increased risk for ischemic stroke (hazard ratio [HR]=1.20; 95% CI, 0.78 to 1.86), myocardial infarction (HR=1.70; 95% CI, 1.04 to 2.77), and death (HR=1.55; 95% CI, 1.23 to 1.96) after adjustment for demographic characteristics and risk factors. Different results among studies may depend on population characteristics such as age and other risk factors. Glucocorticoid (GCT) use is common for the treatment of many different diseases. However, treatment with high-dose GCT is associated with atherosclerosis, diabetes mellitus, and hypertension, and such treatment may increase the risk of cardiovascular disease, including stroke.3 A population-based, case-control study examined whether treatment with GCT was associated with atrial fibrillation,4 which is a well-established risk factor for stroke. All patients with a first hospital diagnosis of atrial fibrillation among a total population of 1.7 million were included, totalling 20 211 patients. Information about GCT treatment was based on linkage to national medical databases. For each case, 10 population controls were selected and matched by age and sex. Current GCT use was associated with an increased risk of atrial fibrillation compared with never use (adjusted odds ratio=1.92; 95% CI, 1.79 to 2.06); in new GCT users, the adjusted odds ratio was 3.62 (95% CI, 3.11 …