Odds ratio and population attributable risk of 10 factors estimated to acount for 90 % of ischemic stroke risk

Risk factor            OR              PAR    (confidence intervals available elsewhere)

 

hypertension          2.64            34.6

current smoking     2.09            18.9

waist to hip ratio    1.65             26.5

Diet risk score       1.35             18.8

Regular exercise    0.69             28.5

Diabetes mellitus   1.36             5.0

ETOH (> 30/mo)     1.51             3.8

Stress/depression   1.30            4.6

Cardiac causes       2.38            6.7

ratio apo B/A1        1.89             24.9

 

Notes

Spouses of smokers have double risk of stroke.  Much benefit of cessation occurs in first 6 months.  Cessation leads to return to baseline risk within five years.

 

Fives risk factors  related to lifestyle and risk

1. Absent current smoking

2. 30 + minutes per day of exercise

3. healthy diet

4.  moderate ETOh consumption

5.  BMI < 25

If all five risk factors are favorable,   RR is -.2, PAR is -53.

 

Cretan Mediterranean diet is the best one; those randomized to it had 70 % less CV events within 27 months

This diet contains more fat esp olive oil.  Its much lower in meat and dairy products and uses fruit as desert. It has high levels of canola nad olive oil, high fruit/vegetable/lentils/beans and nuts.  Avoid trans fats and egg yolks; meat every other day.

 

Ottawa Model of Smoking Cessation

systematic

Identify smoking status-- have you used any form of tobacco in the past six months? The past seven days?

Document-- smoking history (pack years); previous quit attempts, time to first cigarette

Advise--- "There is nothing more important that cessation. We can help you with that"

Pharmacotherapy-- readily available medicine, prescribed appropriately

Followup-- FP; telephone calls; community resources.