• English
    • svenska
  • English 
    • English
    • svenska
  • Login
View Item 
  •   Home
  • Sahlgrenska Academy / Sahlgrenska akademin
  • Institute of Medicine / Institutionen för medicin
  • Doctoral Theses / Doktorsavhandlingar Institutionen för medicin
  • View Item
  •   Home
  • Sahlgrenska Academy / Sahlgrenska akademin
  • Institute of Medicine / Institutionen för medicin
  • Doctoral Theses / Doktorsavhandlingar Institutionen för medicin
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Stroke: Risk Factors and Trends

Abstract
Stroke is a severe disease that affects 30,000 people in Sweden every year. Three quarters of stroke events are first time events. The risk of premature death and disability is high among stroke survivors. Knowledge about risk factors, trends in incidence and prognosis after stroke is important to reduce the risk and improve the outcome. The aim of this thesis was to investigate the long-term risk of coronary heart disease (CHD) and stroke among men from middle age and extending into old age, temporal trends in ischemic stroke (IS) incidence, and prognosis after stroke among younger IS patients (18-54years). For this purpose the Primary Prevention (PPS) study was used in Paper I. Data from the Swedish Inpatient Register (IPR) and Cause of Death Register was used in Paper II to IV.The European Systematic Coronary Risk Evaluation (SCORE) model estimates the 10-year risk of cardiovascular mortality among middle-aged people. This model is based on five risk factors: age, gender, blood pressure, serum cholesterol and smoking status. Paper I showed that the importance of these risk factors differed considerably when estimating the short-term (0-10 years) and long-term (0-35 years) risk of CHD and stroke, such that the prediction was better for CHD than for stroke. During 1987 to 2010 the incidence of IS decreased among elderly (65-84 years) and middle-aged (45- 64 years) people. However, among younger people (18-44 years) the incidence increased about 1.5% per year during the same period of time. From 1987 to 2006 the 4-year mortality risk decreased among young men and women after an IS. Similar findings were observed for recurrent IS. In addition, we observed that most of the decline in recurrence occurred within the first year. In conclusion, this thesis showed that CHD and stroke differs not only by their clinical manifestations but also by how they were influenced by different risk factors at baseline over an extended follow-up. The risk of IS declined for older but not among young people which is a worrying trend but prognosis after stroke has improved over time among younger IS patients, however, the risk of either death or recurrent IS is still high.
Parts of work
I. Giang KW et al. Stroke and coronary heart disease: predictive power of standard risk factors into old age long-term cumulative risk study among men in Gothenburg, Sweden. European Heart Journal (2013) 34, 1068–1074. ::doi::10.1093/eurheartj/ehs458
 
II. Giang KW. Twenty-Four-Year Trends in the Incidence of Ischemic Stroke in Sweden From 1987 to 2010. Stroke. 2013;44:2388-2393. ::doi::10.1161/STROKEAHA.113.001170
 
III. Giang KW. Twenty-Year Trends in Long-Term Mortality Risk in 17 149 Survivors of Ischemic Stroke Less Than 55 Years of Age. Stroke. 2013;44:3338-3343. ::doi:: 10.1161/STROKEAHA.113.002936
 
IV. Giang KW. Trends in Risk of Recurrence after First Ischemic Stroke Among Younger Adults under 55 Years of Age in Sweden (In manuscript).
 
Degree
Doctor of Philosophy (Medicine)
University
University of Gothenburg. Sahlgrenska Academy
Institution
Institute of Medicine. Department of Molecular and Clinical Medicine
Disputation
Fredagen den 21 november kl. 13.00, Hörsal Östraaulan, Centralkliniken, Östra sjukhuset, Diagnosvägen 11
Date of defence
2014-11-21
E-mail
wai.giang.kok@gu.se
URI
http://hdl.handle.net/2077/36742
Collections
  • Doctoral Theses / Doktorsavhandlingar Institutionen för medicin
  • Doctoral Theses from Sahlgrenska Academy
  • Doctoral Theses from University of Gothenburg / Doktorsavhandlingar från Göteborgs universitet
View/Open
Thesis frame (654.2Kb)
Abstract (20.50Kb)
Errata (47.00Kb)
Date
2014-11-04
Author
Giang, Kok Wai
Keywords
Stroke
Ischemic stroke
Risk factors
Incidence
Temporal trends
Mortality
Recurrent ischemic stroke
SCORE
CHD
Prediction
Publication type
Doctoral thesis
ISBN
978-91-628-9195-4
Language
eng
Metadata
Show full item record

DSpace software copyright © 2002-2016  DuraSpace
Contact Us | Send Feedback
Theme by 
Atmire NV
 

 

Browse

All of DSpaceCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

My Account

LoginRegister

DSpace software copyright © 2002-2016  DuraSpace
Contact Us | Send Feedback
Theme by 
Atmire NV