Evidence map›Paper›PMID 33842871›Full record

ArticleEClinicalMedicine2021

Associations of behaviors, biological phenotypes and cardiovascular health with risks of stroke and stroke subtypes: A prospective cohort study.

Zhi Cao, Shu Li, Hongxi Yang, Chenjie Xu, Yuan Zhang, Xueli Yang, Tao Yan, Tong Liu, Yaogang Wang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 19 citations in OpenAlex.

  1. Review
  2. Article
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  6. Review
  7. Polygenic Risk, Midlife Life's Simple 7, and Lifetime Risk of Stroke.Journal of the American Heart Association · 2022
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Zhi CaoSchool of Public Health, Tianjin Medical University, Tianjin, China.
Shu LiSchool of Public Health, Tianjin Medical University, Tianjin, China.
Hongxi YangSchool of Public Health, Tianjin Medical University, Tianjin, China.
Chenjie XuSchool of Public Health, Tianjin Medical University, Tianjin, China.
Yuan ZhangSchool of Public Health, Tianjin Medical University, Tianjin, China.
Xueli YangSchool of Public Health, Tianjin Medical University, Tianjin, China.
Tao YanDepartment of Neurology, Tianjin Neurological and Gerontology Institute, Tianjin Medical University General Hospital, Tianjin, China.
Tong LiuDepartment of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
Yaogang WangSchool of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Medical University · CNSecond Hospital of Tianjin Medical University · CNTianjin Medical University General Hospital · CN

Funding

British Heart Foundation CH/1996001/9454Medical Research Council MC_PC_17228Medical Research Council MC_QA137853
6 · The paper itself

Abstract

backgroundAlthough many cardiovascular risk factors for stroke have been reported before, it has not been investigated comprehensively for all major stroke types in large datasets. This study aimed to evaluate the associations of healthy behaviors, biological phenotypes and cardiovascular health (CVH) with long-term risks of strokes events, overall and stroke subtypes (ischemic stroke [IS], intracerebral hemorrhage [ICH], subarachnoid hemorrhage [SAH], and unspecified stroke).

methodsBetween 2006 and 2010, a total of 354,976 participants (age 40-70 years) in the UK Biobank free of stroke and coronary heart disease were examined and thereafter followed up to 2020. According to American Heart Association guideline, the global CVH included four behavioral (smoking, diet, physical activity, body mass index) and three biological (blood glucose, blood cholesterol, blood pressure) metrics. The behavioral, biological and global CVH score was the sum of four, three, and seven metrics, respectively, and then was categorized into poor, intermediate and ideal group. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke events.

findingsA total of 5804 incident stroke cases, including 3664 IS, 714 ICH and 453 SAH, were documented over a median follow-up of 11 years. The risk of stroke decreased significantly and linearly with both increasing behavioral CVH score and biological CVH score. Ideal behavioral CVH group was significantly associated with lower risks of all stroke subtypes, biological CVH was related to stroke events except for SAH. Additionally, the 1-point increment in global CVH score was associated with 11%,13%, 8% and 13% lower risks of stroke, IS, ICH and unspecified stroke, however, there was no significant dose-dependent association between global CVH and SAH.

interpretationOur findings suggest inverse linear associations of behavioral, biological and global CVH with long-term risks of stroke and stroke subtypes, except for SAH, highlighting the benefits of maintaining better CVH status as a primordial prevention strategy of stroke.

fundingThe National Natural Science Foundation of China (71,910,107,004, 91,746,205).

Indexed as

Cardiovascular healthCohort studyPrimordial preventionStroke

Identifiers

PMID33842871
PMCPMC8020159
OpenAlexW3139407055

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.