Comparison of risk factors for fatal stroke and ischemic heart disease: A prospective follow up of the health survey for England

Abstract

ObjectivesThe aim was to compare risk factors for stroke and ischemic heart disease (IHD) in a large general population cohort. MethodsA prospective cohort of 82,380 participants (aged 55.4 [SD 14.2 yrs], 44.8% men) without known history of cardiovascular diseases (CVD) at baseline was pooled from ten years (1994–2004) of the Health Survey for England. Study members were followed, on average, over 8 years for cause-specific mortality using linkage to national registers. ResultsThere were 806 and 1346 stroke and IHD deaths, respectively. The major risk factors for stroke included age (hazard ratio [HR]=1.15, 95% CI, 1.13–1.17), smoking (HR=1.71; 1.20–2.44), diabetes (HR=1.75; 1.05–2.93), total cholesterol (HR per SD=0.78; 0.69–0.89), and systolic BP (HR per SD=1.22; 1.08–1.38). In addition to these risk factors, IHD was also predicted by high density lipoprotein cholesterol, body mass index, C-reactive protein, and fibrinogen. This pattern of results was consistent among younger (<70 yrs) and older adults. ConclusionIn a large representative cohort of the general population we found a differential pattern of risk markers for stroke compared with IHD. This was not explained by differences in age at onset of disease.