ArticleStroke2022
Risk Factor Characterization of Ischemic Stroke Subtypes Among West Africans.
Open access · bronzeAbstract readMulticenter Study
In one paragraph
Article in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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17citing papers in PubMed, 3 pooled it
2.3field-weighted citation impact, top 11% of its field
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The trial behind it
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Psychosocial stress and risk of first-ever stroke: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Development of a high-performing, cost-effective and inclusive Afrocentric predictive model for stroke: a meta-analysis approach.BMC neurology · 2025Pooled it
- TNF-α (G-308A) Polymorphism, Circulating Levels of TNF-α and IGF-1: Risk Factors for Ischemic Stroke-An Updated Meta-Analysis.Frontiers in aging neuroscience · 2022Pooled it
- Effect of a Cardiovascular Polypill on Poststroke Cognition Among Ghanaians: Secondary Analysis of a Randomized Clinical Trial.Journal of the American Heart Association · 2024Trial
- Epidemiology and future trend predictions of ischemic stroke based on the global burden of disease study 1990-2021.Communications medicine · 2025Article
- Association between alcohol consumption and stroke in Nigeria and Ghana: A case-control study.International journal of stroke : official journal of the International Stroke Society · 2025Article
- Confounder adjustment in observational studies investigating multiple risk factors: a methodological study.BMC medicine · 2025Article
- Analysis of Risk Factors for Acute First-Ever Ischemic Stroke in the Elderly Population of Eastern Liaoning Province: A Case-Control Study.International journal of general medicine · 2025Article
- A comparative analysis of TOAST and ASCOD criteria in etiologic subtyping of acute ischemic stroke at a tertiary hospital in Tanzania.Frontiers in stroke · 2025Article
- Epigenetics as a target to mitigate excess stroke risk in people of African ancestry: A scoping review.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2024Article
- Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study.Journal of the neurological sciences · 2024Article
- [Evaluation of the management of hypertension among stroke patients in a neurology department of Côte d'Ivoire].Medecine tropicale et sante internationale · 2024Article
- Behavioural and nutritional risk factors for cardiovascular diseases among the Ghanaian population- a cross-sectional study.BMC public health · 2024Article
- A potential relationship betweenFrontiers in neurology · 2023Article
- Differential associations between pre-diabetes, diabetes and stroke occurrence among West Africans.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Long-term determinants of death after stroke in Ghana: Analysis by stroke types & subtypes.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Analysis of Clinical Symptoms and Risk Factors Related to Functional Prognosis in Patients With Cardiogenic Stroke.Texas Heart Institute journalArticle
Corrections and comments
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Authors and funding
89 authors at 20 institutions in 4 countries.
Fred S SarfoDepartment of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.S., A.S., D.O.).ORCID 0000-0001-7274-5093
Bruce OvbiageleWeill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).ORCID 0000-0002-9958-0644
Onoja AkpaDepartment of Epidemiology and Medical Statistics (O.A., O.J.A.), an College of Medicine, University of Ibadan.
Albert AkpaluCollege of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.ORCID 0000-0002-4802-9852
Kolawole WahabDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).ORCID 0000-0002-2914-1953
Reginald ObiakoDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).ORCID 0000-0003-1769-8110
Morenikeji KomolafeDepartment of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).ORCID 0000-0002-0592-5120
Lukman OwolabiDepartment of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).
Godwin OgboleDepartment of Radiology (G.O.), an College of Medicine, University of Ibadan.ORCID 0000-0003-0431-7198
Benedict Calys-TagoeDepartment of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).ORCID 0000-0002-6133-240X
Adekunle FakunleDepartment of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
Taofeek SanniFederal Teaching Hospital, Ido-Ekiti, Ado-Ekiti, Nigeria (T.S., E.O.).
Gebregziabher MulugetaMedical University of South Carolina, Charleston (G.M., C.J., D.T.L.).ORCID 0000-0002-4826-481X
Salaam AbdulJos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
Adeseye A AkintundeLadoke Akintola University of Technology/Teaching Hospital, Ogbomosho, Nigeria (A.A.A.).
Samuel OlowookereDepartment of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).
Ezinne O UvereDepartment of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
Philip IbinaiyeDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).ORCID 0000-0002-8602-4251
Joshua AkinyemiCollege of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
Kelechukwu UwanuruochiFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).ORCID 0000-0002-3397-1511
Balogun OlayemiDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
Olufemi A OdunlamiFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
Esther AbunimyeDepartment of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).ORCID 0000-0001-8467-814X
Oyedunni ArulogunPreventive Cardiology Research Unit, Institute of Cardiovascular Diseases (O.A., O.J.A.), an College of Medicine, University of Ibadan.ORCID 0000-0002-2173-4682
Suleiman Y IsahDepartment of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).ORCID 0000-0003-2313-6915
Sani A AbubakarDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
Adebayo OladimejiORCID 0000-0001-7096-4460
Philip AdebayoUniversity College Hospital, Ibadan, Nigeria Aga Khan University Dar es Salaam, Tanzania (P.A.).
Vincent ShidaliFederal Medical Centre, Keffi Zaria, Nigeria (V.S.).
Innocent I ChukwuonyeFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).ORCID 0000-0003-1190-135X
Josephine AkpaluDepartment of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).ORCID 0000-0002-2873-3703
Moyinoluwalogo M Tito-IloriDepartment of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
Osahon J AsowataWeill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).
Emmanuel O SanyaDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
Ganiyu AmusaJos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).ORCID 0000-0002-1388-0639
Ugochukwu OnyeonoroFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).ORCID 0000-0003-2132-6221
James A OgunmodedeDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).ORCID 0000-0003-1677-1232
Abdullateef G SuleDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
Cynthia AkisanyaFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).ORCID 0000-0003-1522-099X
Yaw MensahKorle Bu Teaching Hospital, Accra, Ghana (Y.M.).
Olalekan I OyinloyeDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
Lambert AppiahKomfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
Atinuke M AgunloyeCollege of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
Godwin O OsaigbovoJos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
Eunice OlabinriFederal Teaching Hospital, Ido-Ekiti, Ado-Ekiti, Nigeria (T.S., E.O.).ORCID 0000-0003-3948-7111
Philip M KoloDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).
Obiora OkekeFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
Abiodun M AdeoyeCollege of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.ORCID 0000-0002-0175-1768
Olabamiji AjoseCollege of Medicine (J.A., O.A., A.M.A., A.M.A., A.A.), an College of Medicine, University of Ibadan.
Carolyn JenkinsMedical University of South Carolina, Charleston (G.M., C.J., D.T.L.).
Daniel T LacklandMedical University of South Carolina, Charleston (G.M., C.J., D.T.L.).ORCID 0000-0001-5733-6283
Adedeji A EgberongbeFederal Medical Centre, Owo, Ondo State, Nigeria (A.A.E.).
Olaleye AdenijiFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).ORCID 0000-0002-3402-7768
Osimhiarherhuo Ohifemen AdeleyeFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).ORCID 0000-0001-8941-7715
Hemant K TiwariUniversity of Alabama at Birmingham, Alabama (H.K.T.).
Donna ArnettCollege of Public Health, University of Kentucky (D.A., J.I.).ORCID 0000-0003-2219-657X
Ruth Y LaryeaDepartment of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).
Taiwo OlunugaFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
Kazeem S AkinwandeFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
Lucius ImohJos University Teaching Hospital Jos, Nigeria (S.A., G.A., G.O.O., L.I.).
Okechukwu S Ogah
Ezinne S Melikam
Adeyemo AdebolajiDepartment of Medicine, University of Ghana Medical School, Accra (A.A., B.C.-T., J.A., R.Y.L.).
Wisdom OguikeDepartment of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., P.I., B.O., S.A.A., A.G.S., W.O.).
Olumayowa OgunronbiFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).ORCID 0000-0003-4104-2728
Wasiu AdeniyiFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
Obiabo Y OlugboDelta State University/Delta State University Teaching Hospital, Oghara, Nigeria (O.Y.O.).
Abiodun H BelloDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria (K.W., E.O.S., J.A.O., O.I.O., P.M.K., A.H.B.).ORCID 0000-0002-2078-6739
Kenneth A OhagwuFederal Medical Centre Umuahia, Nigeria (K.U., I.I.C., U.O., O.O., K.A.O.).
Luqman OgunjimiDepartment of Pharmacology and Therapeutics, Olabisi Onabanjo University. Abeokuta, Nigeria (L.O.).ORCID 0000-0001-9185-9774
Francis AgyekumGreater Accra Regional Hospital, Accra, Ghana (F.A.).ORCID 0000-0002-7901-168X
Henry IheonyeFederal Medical Centre, Lokoja, Kogi state, Nigeria (H.I.).ORCID 0000-0003-2337-2969
Julius AdesinaFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).
Samuel DialaDepartment of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.
Hamisu A DambattaDepartment of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., E.A., S.Y.I., H.A.D.).
Joyce IkuborCollege of Public Health, University of Kentucky (D.A., J.I.).ORCID 0000-0002-5170-1830
Arti SinghDepartment of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.S., A.S., D.O.).
Sheila AdamuKomfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
Vida ObeseKomfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
Nathaniel AduseiKomfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
Dorcas OwusuDepartment of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.S., A.S., D.O.).ORCID 0000-0003-4299-5870
Michael AmpofoKomfo Anokye Teaching Hospital Kumasi, Ghana (L.A., S.A., V.O., N.A., M.A.).
Raelle TaggeWeill Institute for Neurosciences, School of Medicine, University of California San-Francisco (B.O., O.J.A., R.T.).
Richard Efidi
Bimbo FawaleDepartment of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria (M.K., S.O., O.A., B.F.).
Joseph Yaria
Rufus AkinyemiFederal Medical Centre, Abeokuta, Nigeria (O.A.O., C.A., O.A., O.O.A., T.O., K.S.A., W.A., J.A., R.A.).ORCID 0000-0001-5286-428X
Mayowa OwolabiDepartment of Medicine (A.F., E.O.U., M.M.T.-I., M.O.,S.D., M.O.), an College of Medicine, University of Ibadan.ORCID 0000-0003-1146-3070
SIREN
Federal Medical Centre · NGUniversity of Ibadan · NGAhmadu Bello University · NGFederal Medical Centre · NGUniversity of Ilorin Teaching Hospital · NGAnna Needs Neuroblastoma Answers · USKomfo Anokye Teaching Hospital · GHAminu Kano Teaching Hospital · NGJos University Teaching Hospital · NGUniversity of Ghana · GHKwame Nkrumah University of Science and Technology · GHMedical University of South Carolina · USObafemi Awolowo University Teaching Hospitals Complex · NGUniversity of California, San Francisco · USEkiti State University · NGUniversity of Kentucky · USAga Khan Hospital Dar es Salaam · TZDelta State University · NGFederal Medical Centre · NGGhana Health Service · GH
Funding
University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BARBARA A GOWER · 2013 to 2026
$19.5MStroke Investigative Research & Educational Network (SIREN)U54HG007479 · NHGRI · COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN · PI OVBIAGELE, BRUCE, OWOLABI, MAYOWA OJO · 2013 to 2017
$4.2MAfrican Rigorous Innovative Stroke Epidemiological Surveillance (ARISES)R01NS115944 · NINDS · COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN · PI OVBIAGELE, BRUCE, OWOLABI, MAYOWA OJO · 2020 to 2025
$2.2MSystematic Investigation of Blacks with Stroke - Genomics (SIBS-Genomics) StudyR01NS107900 · NINDS · COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN · PI OVBIAGELE, BRUCE, OWOLABI, MAYOWA OJO · 2018 to 2021
$1.8MTraining Africans to Lead and Execute Neurological Trials & Studies (TALENTS)D43TW012030 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI OVBIAGELE, BRUCE · 2021 to 2025
$1.2MFIC NIH HHS D43 TW012030NHGRI NIH HHS U54 HG007479NIDDK NIH HHS P30 DK079626NINDS NIH HHS R01 NS107900NINDS NIH HHS R01 NS115944
Abstract
background and purposeTo identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans.
methodsThe SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI.
resultsThere were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 427 (17.6%) large-artery atherosclerosis, 258 (10.6%) cardio-embolic, 3 (0.1%) carotid dissections, and 719 (29.6%) undetermined/other causes. The adjusted odds ratio (95% CI) for the 8 dominant risk factors for ischemic stroke were hypertension, 10.34 (6.91-15.45); dyslipidemia, 5.16 (3.78-7.03); diabetes, 3.44 (2.60-4.56); low green vegetable consumption, 1.89 (1.45-2.46); red meat consumption, 1.89 (1.45-2.46); cardiac disease, 1.88 (1.22-2.90); monthly income $100 or more, 1.72 (1.24-2.39); and psychosocial stress, 1.62 (1.18-2.21). Hypertension, dyslipidemia, diabetes were confluent factors shared by small-vessel, large-vessel and cardio-embolic subtypes. Stroke cases and stroke-free controls had a mean of 5.3±1.5 versus 3.2±1.0 adverse cardio-metabolic risk factors respectively (
conclusionsTraditional vascular risk factors demonstrate important differential effect sizes with pathophysiologic, clinical and preventative implications on the occurrence of ischemic stroke among indigenous West Africans.
Indexed as
Africa, WesternAgedCase-Control StudiesDiabetes MellitusDyslipidemiasFemaleGhanaHumansHypertensionIschemic StrokeMaleMiddle AgedNigeriaObesityRisk Factorsatherosclerosisdyslipidemiahypertensionischemic strokerisk factors
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