Browse > Article

Body Mass Index and Risk of Hemorrhagic Stroke in Korean Adults: Case-control Study  

Kim, Seon-Ha (Department of Preventive Medicine, Seoul National University College of Medicine)
Lee, Yong-Seok (Department of Neurology, Seoul National University Boramae Hospital)
Lee, Seung-Mi (Department of Preventive Medicine, Seoul National University College of Medicine)
Yoon, Byung-Woo (Department of Neurology, Seoul National University College of Medicine)
Park, Byung-Joo (Department of Preventive Medicine, Seoul National University College of Medicine)
Publication Information
Journal of Preventive Medicine and Public Health / v.40, no.4, 2007 , pp. 313-320 More about this Journal
Abstract
Objectives : To evaluate the association between body mass index (BMI) and hemorrhagic stroke. Methods : A case-control study was conducted on 2,712 persons (904 cases, 904 hospital controls, and 904 community controls) participating in an Acute Brain Bleeding Analysis study from October 2002 to March 2004. Two controls for each case were matched according to age and gender. The information was obtained by trained interviewers using standardized questionnaire. A conditional logistic regression model was used to estimate the association between BMI and the frequency of having a hemorrhagic stroke. Results : Obese men (25.0 $\leq$ BMI < $30.0\;kg/m^2$) had an odds ratios (OR) of 1.39 (95% CI 1.03 to 1.87) a hemorrhagic stroke, compared to men with a normal BMI (18.5 to $24.9\;kg/m^2$). Conversely, women with lower BMI had a higher risk of having hemorrhagic stroke. With respect to subtypes of hemorrahagic stroke, we observed about a three-fold increase in the risk of intracerebral hemorrhage (ICH) in the highly obese group. However, these trends were not significant in patients with subarachnoid hemorrhages. Conclusions : Obesity was identified as one of the risk factors in hemorrhagic stroke, in particular ICH. Conversely, in women, a lean body weight increases the risk of hemorrhagic stroke. Consequently, managing one's weight is essential to reduce the risks of hemorrhagic stroke.
Keywords
Body mass index; Cerebrovascular accident; Cerebral hemorrhage; Obesity; Korea;
Citations & Related Records

Times Cited By SCOPUS : 3
연도 인용수 순위
1 Kang SD, Jeong JW, Moon BS, Kim JM. Current epidemiological status of cerebrovascular disease. J Korean Neurosurg Soc 1999; 28(4): 509-513 (Korean)
2 Yoon SJ, Yi SW, Kim SY, Ohrr HC, Park YH, Lee SY, Sohn TY. Association between BMI and mortality-Kangwha cohort study. Korean J Prev Med 2000; 33(4): 459-468 (Korean)
3 Isozumi K. Obesity as a risk factor for cerebrovascular disease. Keio J Med 2004; 53(1): 7-11   DOI   PUBMED   ScienceOn
4 Rexrode KM, Hennekens CH, Willett WC, Golditz GA, Stampfer MJ, Rich-Edwards JW, Sepizer FE, Manson JE. A prospective study of body mass index, weight change, and risk of stroke in women. JAMA 1997; 277(19): 1539-1545   DOI   ScienceOn
5 Kurth T, Gaziano JM, Berger K, Rexrode KM, Kase CS, Rexrode KM, Cook NR, Buring JE, Manson JE. Body mass index and the risk of stroke in men. Arch Intern Med 2002; 162(22): 2557-2562   DOI   ScienceOn
6 Kim HC, Kang DR, Nam CM, Hur NW, Shim JS, Jee SH, Suh I. Elevated serum aminotransferase level as a predictor of intra cerebral hemorrhage. Stroke 2005; 36(8): 1642-1647   DOI   ScienceOn
7 Yamada S, Koizumi A, Iso H, Wada Y, Watanabe Y, Date C, Yamamoto A, Kikuchi S, Inaba Y, Toyoshima H, Kondo T, Tamakoshi A; Japan Collaborative Cohort Study Group. Risk factors for fatal subarachnoid hemorrhage: The Japan collaborative cohort study. Stroke 2003; 34(12): 2781-2787   DOI   ScienceOn
8 Rodriguez BL, D' Agostino R, Abbott RD, Kagan A, Brchfiel CM, Yano K, Ross W, Silbershatz H, Higins MW, Popper J, Wolf PA, Curb JD. Risk of hospitalized stroke in men enrolled in the Honolulu heart program and the Framingham study: A comparison of incidence and risk factor effects. Stroke 2002; 33(1): 230-237   DOI   ScienceOn
9 Korea Health Industry Development Institute. Korea national health and nutrition examination survey in 2001: Nutrition survey. Seoul:Korea Health Industry Development Institute; 2003. p.273 (Korean)
10 Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999; 282(16): 1523-1529   DOI   ScienceOn
11 Ni Mhurchu C, Rodgers A, Pan WH, Gu DF, Woodward M, Asia Pacific Cohort Studies Collaboration. Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310,000 participants. Int J Epidemiol 2004; 33(4): 751-758   DOI   PUBMED   ScienceOn
12 Shaper AG, Wannamethee SG, Walker M. Body weight: implications for the prevention of coronary heart disease, stroke, and diabetes mellitus in a cohort study of middle aged men. BMJ 1997; 314(7090): 1311-1317   DOI   PUBMED   ScienceOn
13 Cui R, Iso H, Toyoshima H, Date C, Yamamoto A, Kikuchi S, Konddo T, Watanae Y, Koizumi A, Wada Y, Inaba Y, Tamkoshi A, JACC study group. Body mass index and mortality from cardiovascular disease among Japanese men and women The JACC study. Stroke 2005; 36(7): 1377-1382   DOI   ScienceOn
14 Song YM, Sung JH. Body mass index and mortality; A twelve-year prospective study in Korea Epidemiology 2001; 12(2): 173-179   DOI   ScienceOn
15 Kurth T, Gaziano JM, Bdrger K, Rexrode KM, Kase CS, Cook NR, Manson JE, Buring JE. Prospective study of body mass index and risk of stroke in apparently healthy women. Circulation 2005; 111(15): 1992-1998   DOI   ScienceOn
16 Goldstein LB, Adams R, Becker K, Furberg CD, Gorelick PB, Hademenos G, Hill M, Howard G, Howard VJ, Jacobs B, Levine SR, Mosca L, Sacco RL, Sherman DG, Wolf PA, del Zappa GJ. Primary prevention of ischemic stroke; A statement for healthcare professionals from the stroke council of the American heart association. Stroke 2001; 32(1): 280-299   DOI   PUBMED   ScienceOn
17 Song YM, Sung JH, Smith GD, Ebrahim S. Body mass index and ischemic and hemorrhagic stroke - A prospective study in Korean men. Stroke 2004; 35(4): 831-836   DOI   ScienceOn
18 Korea National Statistical Office. Reports on death causes [cited 2007 Mar 21]; Available from URL: http://kosis.nso.go.kr:7001/ups/chapterRetrieve.jsp?pubcode=MA&seq=240&pub=3 (Korean)
19 World Health Organization. Obesity: preventing and managing the global endemic. WHO technical report series no 894. Geneva: WHO;2000,p.18
20 Jood K, Jem C, Willhelmsen L, Rosengren A. Body mass index in mid-life is associated with a first stroke in men - A prospective papulation study over 28 years. Stroke 2004; 35(12): 2764-2769   DOI   ScienceOn
21 Oki I, Nakamura Y, Okamura T, Okayama A, Hayakawa T, Kita Y, Ueshima H, NIPPON DATA80 Group. Body mass index and risk of stroke mortality among a random sample of Japanese adults: 19-year follow-up of NIPPON DATA80. Cerebrovasc Dis 2006; 22(5-6): 409-415   DOI   ScienceOn
22 Bae HJ. Classification and pathophysiology of stroke. Med Postgrad 2001; 29(1): 68-74 (Korean)
23 Feigin V, Prarg V, Lawes CMM, Rodgers A, Suh I, Woodward M, Jamrozik K, Ueshima H, Asia Pacific Cohort Studies Collaboration. Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-pacific region: An overview of 26 cohorts involving 306620 participants. Stroke 2005; 36(7): 1360-1365   DOI   ScienceOn
24 Ministry of Health and Welfare. Korea national health and nutrition examination survey in 2001-Health examination. Seoul: Ministry of Health and Welfare, 2002. p.352-354 (Korean)
25 Kim NS, Moon OR, Kang JH, Lee SY, Jeong BG, Lee SJ, Yoon TH, Hwang KH. Increasing prevalence of obesity related disease for Koreans associated with overweight and obesity. Korean J Prev Med 2001; 34(4): 309- 315 (Korean)
26 Thrift AG, McNeil JJ, Forbes A, Donnan G. Risk factors for cerebral hemorrhage in the era of well-controlled hypertension. Stroke 1996; 27(11): 2020-2025   DOI   PUBMED   ScienceOn
27 Yoon BW, Bae HJ, Hong KS, Lee SM, Park BJ, Yu KH, Han MK, Lee YS, Chung DK, Park JM, Jeong SW, Lee BC, Cho KH, Kim JS, Lee SH, Yoo KM, Acute Brain Bleeding Analysis (ABBA) Study Investigators. Phenylpropanolamine contained in cold remedies and risk of hemorrhagic stroke. Neurology 2007; 68(2): 146-149   DOI   ScienceOn