Biological And Psychosocial Risk Factors Of Stroke In African Americans Enrolled In The Jackson Heart Study (JHS)
Objectives: the objective of this study is to estimate the impact of biological, psychosocial and other risk factors on stroke in African Americans enrolled in the JHS and determine the population attributable risk of risk factors. Methods: this study used a nested case control design. Cases were patients with stroke during the follow up period. Corresponding controls were selected from subjects who are alive at that time period and who are at risk of stroke by matching on the person-years spent in the cohort. Odds ratios (OR) and population attributable risks (PAR) were calculated to understand the association of risk factors with incident stroke. Results: a total of 129 cases of incident stroke were identified during the follow-up and 590 controls were identified. Hypertension and diabetes were the two strongest risk factors of stroke, with an OR of 1.8 (95% ci 1.1 - 3.1) for hypertension and an OR of 1.7 (95% ci 1.1 - 2.7) for diabetes, folloby the Framingham stroke risk score. The risk of stroke increased by 4% for every 1% increase in the Framingham stroke risk score (or 1.04, 95% ci 1.01 - 1.08). Family history of stroke and alcohol consumption increased the risk of stroke, but the association was not significant. We found that psychosocial risk factors including depression, stress and major life events were not significantly associated with incident stroke in this study. The overall par including both biological and psychosocial risk factors accounted for 77.5% of incident stroke in our study. Conclusions: in conclusion, the six biological risk factors together accounted for 76.5% of PAR in the African Americans in the JHS. The association of psychosocial risk factors and incident stroke is unclear and further studies are necessary.
African Americans, Jackson Heart Study, Odds Ratios, Population Attributable Risk, Risk Factors, Stroke, Epidemiology
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