Issue 135 Item 3 Greater Stroke Risk in Men With Body Mass Index of 30 or Greate

Risk of stroke increases significantly as body mass index (BMI) increases. That, according to a report in the December 9th and 23rd issue of the Archives of Internal Medicine, from new data from the US Physicians’ Health Study.

Dr. Tobias Kurth said that, "There is a clear linear association between BMI and stroke, which holds true for total, ischemic, and hemorrhagic stroke, and is independent of possible biological mediators such as hypertension, diabetes, and high cholesterol."

Dr. Kurth, from Brigham and Women’s Hospital, Boston, and colleagues collected data on 21,414 men who participated in the Physicians’ Health Study. The researchers looked for incidence of stroke and compared these with BMI.

There were 747 stroke during 12.5 years of follow-up, the researchers found. Of these 631 were ischemic and 104 were hemorrhagic with 12 undefined.

Men with a BMI of 30 or greater were at a significantly greater risk for stroke compared with men whose BMI was less than 25 (relative risk 1.91 for total stroke, 1.87 for ischemic stroke and 1.92 for hemorrhagic stroke), Dr. Kurth’s team reports.

As a continuous variable, each 1-unit increase in BMI was associated with a 6% increase in relative risk for all stroke, they add. The risk for ischemic stroke was slightly attenuated by adjusting for hypertension, diabetes and hypercholesterolemia. However, these adjustments did not alter the risk for hemorrhagic stroke, they note.

"Since the numbers of adults, in particular young adults who are overweight and obese is rising in the US and industrial countries and stroke is the main cause of disability and third leading cause of death, the study results are even more important," Dr. Kurth said.

"This study provide evidence that staying lean modifies your risk of stroke and physicians should consider increased risk of stroke another hazard of obesity. We hope that physicians will focus more on obesity as target for stroke prevention," he stressed. Arch Intern Med 2002;162:2557-2562.