• Biomedical Science Letters
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• v.24 no.4
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• pp.405-410
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• 2018

Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

• The Journal of Korean Medicine
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• v.28 no.4
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• pp.42-51
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• 2007

Background and Purpose : To prevent ischemic cerebral infarction, it is very important to reduce risk factors which might cause stroke. However, the relationship of coffee consumption with ischemic cerebral infarction still remains unclear. The purpose of this study was to investigate the effects of coffee consumption on the risk of ischemic cerebral infarction in Koreans. Methods : A case-control study was conducted from April 1, 2001 to July 31, 2004. Cases (n=435) of first incident ischemic cerebral infarction were enrolled and were mostly matched by age to stroke-free hospital controls (n=407). All subjects were interviewed, examined and had anthropometric measurements by using an organized questionnaire. The coffee consumption was classified by the average frequency of intake, being none, 1 cup/day, 2-4 cups/day, more than 5 cups/day. Odds ratios (ORs) of ischemic cerebral infarction were proved multivariate analysis after adjustment for demographic factors, diet factors, and vascular risk factors. Results : When adjusted for sex, age, and other factors, coffee consumption and stroke do not have a significant association. (${\leq}$ cup/day OR=1.035, 95% CI=0.880-2.756; 2-4cups/day OR=1.452, 95% CI=0.864-2.440; ${\geq}$ 5 cups/day OR=1.557, 95% CI=0.705-3.435) Conclusions : In this study, we conclude that coffee consumption is not an important risk factor of ischemic cerebral infarction in Koreans. Prospective and cohort study on the relation between coffee consumption and the possibility of inducing ischemic cerebral infarctions in Koreans will be required in the future.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.359-364
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• 2006

Objectives: The object of this study is to assess the relationship between socioeconomic factors and the predicted 10-year risk of cardiovascular disease by using health risk appraisal of ischemic heart disease. Methods: The study population was taken from The 2001 Korea National Health and Nutrition Survey, and it consisted of 1,566 men and 1,984 women aged 30-59. We calculated 10-year risk using the risk function of ischemic heart disease as developed by Jee. The educational level and equivalized household income were dichotomized by a 12 years education period and the median income level. Occupation was dichotomized into manual/non-manual work. We stratified the population by age(10 years) and sex, and then we rated the risk differences according to socioeconomic factors by performing t-tests for each strata. Results: There were gradients of the predicted 10-year risk of ischemic heart disease with the educational level and the equivalized household income, and thet was an increasing tendency of risk differences with age. Manual workers didn't show significant risk difference from non-manual workers. Conclusions: There was definite relationship between low socioeconomic position and the predicted risk of ischemic heart disease in the future.

• The Journal of Korean Medicine
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• v.27 no.1 s.65
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• pp.118-129
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• 2006

Objectives : A human being is classified into 4 constitutions(Taeyangin, Soyangin, Taeumin, and Souemin) and each constitution has the different incidence, treatment and prevention of disease in Sasang Constutional Medicine[SCM], The purpose of this study is to find relative risk(RR)s of each risk factors including Sasang Constitution[SC] for incidence of ischemic stroke. Methods : In 344-case patients with ischemic stroke and 1446 healthy control subjects without ischemic stroke, we evaluated sex, age. height, weight, BMI, ECG abnormality, hypertension, diabetes mellitus, blood lipid level and SC. These data were statistically analysed to investigate the relations between risk factors and the incidence of ischemic stroke by chi-square test. And then significant factors were analysed to get each adjusted odds ratio[OR] by binary logistic regression analysis. Results : ECG abnormality, hypertension, diabetes mellitus, HDL(high density lipoprotein) cholesterol, and SC were significantly related to the incidence of ischemic stroke, while age, sex and BMI were adjusted in a binary logistic regression analysis. Especially in SC, the incidence of ischemic stoke in Tae-eumin and Soyangin were higher than that in Soeumin (Tae-eumin OR=11.68[95% CI: 6.26-21.80], Soyangin OR=4.64[95% CI: 2.66-8.10]). Conclusions : These results suggested that SC may be one of important risk factors for ischemic stroke and it should be a useful data for prediction of incidence of ischemic stroke.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.872-885
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• 2007

Objective : Stroke is one of the most common causes of death in Korea. This study was done to evaluate the association of complete blood count (CBC) with the risk of hemorrhagic stroke and ischemic stroke. Methods : In 217-case patients with ischemic stroke or hemorrhagic stroke and 146 healthy control subjects without stroke, hypertension, diabetes mellitus, hyperlipidemia, or ischemic heart disease and 160 controls without ischemic stroke or hemorrhagic stroke, we tested and compared white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hgb), hematocrit (Hct) and platelet. These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Results :The level of WBC was significantly higher in all cases. The level of RBC, Hct and Hgb was significantly lower in patients of ischemic stroke. The level of platelet was significantly higher in patients of ischemic stroke. Conclusion : These results suggest high WBC may be a risk factor of hemorrhagic stroke and ischemic stroke and low RBC, low Hct, low Hgb and high platelet may be risk factors of ischemic stroke in Koreans.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.262-274
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• 2007

Objective : It has been reported that two-repeats ($IL1RN^{\ast}2$) of interleukin-1 receptor antagonist (IL-1Ra) gene is associated with ischemic stroke, and that Ala allele of the common Pro12Ala polymorphism in $PPAR-{\gamma}2$ isoform is associated with reduced risk for type 2 DM and its complications. The aim of the present study is to assess the association of IL-1Ra and $PPAR-{\gamma}2$ Pro12Ala polymorphism with the presence of ischemic stroke in the case of diabetic and non-diabetic patients. Methods : Genomic DNA was obtained from 373 healthy subjects, 157 DM subjects without ischemic stroke (known DM duration ${\ge}10$ years) and 302 ischemic stroke patients (including with DM). IL-1Ra polymorphism was analysed by polymerase chain reaction (PCR), and $PPAR-{\gamma}2$ polymorphism by restriction fragment length polymorphism after PCR. Results : $IL1RN^{\ast}1/IL1RN^{\ast}2$ genotype was associated with significantly increased risk for DM (OR=2.86, P = 0.0008) and ischemic stroke (OR=2.74, P = 0.0016). Pro/Ala genotype was associated with the reduced risk for DM (OR=0.53, P = 0.0491) and ischemic stroke (OR=0.38, P = 0.0039). They were also associated with the reduced risk for ischemic stroke in the DM patients compared with DM without ischemic stroke (OR=0.25, P = 0.0321). Conclusions : $IL1RN^{\ast}2$ allele could be an accelerating factor, not a predictive marker for ischemic stroke in type 2 DM. The Pro/Ala genotype of $PPAR-{\gamma}2$ Pro12Ala polymorphism may be associated with reduced risk for ischemic stroke with type 2 DM. Therefore it could be a useful predictive marker for ischemic stroke in Korean type 2 DM.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.423-431
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• 1993

To eveluate the risk factors which are related to recurrence of ischemic stroke, we selected subjects who were admitted to YNUH due to recurrent stroke and compared their risk factors with non-recurred group who suffered from single ischemic stroke. In the subjects, 55 of them are men and 22 were women and in the non-recurred groups, 84 of them were men and 40 were women, Subject's age ranged from 29 to 85 years(Mean 62, 5years), and non-recurred group's age ranged from 27 to 90 years(Mean 60, 7years), Peak incidence of ischemic stroke is in the 7th decade in both groups. Age and sex are not, statistically significant for recurrence of ischemic stroke. The patient's history of diabetes mellitus, myocardial infarction, atrial fibrillation, transient attack and type or site of ischemic stroke had no significant effect statistically on the recurrent ischemic stroke. However, when the patient had previous history of hypertension or systolic blood pressure more than 160mmHg and diastolic more than 95mmHg, there was substantial difference(P<0.05) between the two group in the recurrence of ischemic stroke. According to the above results, hypertension is most likely significant risk factor of the recurrence of ischemic stroke within 2years after initial one. Therefore, adequate treatment of the hypertension is important for the prevention of ischemic stroke. Further study is required for searching other risk factors.

• The Journal of Korean Medicine
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• v.24 no.4
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• pp.19-24
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• 2003

Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95％ confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95％ CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95％ CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95％ CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.

• The Journal of Korean Medicine
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• v.29 no.2
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• pp.1-6
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• 2008

Objectives: This study aimed to investigate the seasonal variation in stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions. Methods: 226 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from November 2005 to October 2006. The year was subdivided into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions in the four groups were examined. Results: Ischemic stroke was most frequent in summer, whereas hemorrhagic stroke was most frequent in winter. There was no significant difference in seasonal variation of stroke. The frequency of ischemic heart disease among stroke risk factors was significantly high in spring (p=0.031). The frequency of hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia did not differ among seasons. There was no significant difference in Sasang constitution among seasons. Frequency of small vessel occlusion was highest in summer. Large artery atherosclerosis was frequent in spring and summer,but seasonal variation of ischemic stroke subtypes did not show statistical difference. Conclusion: Acute stroke demonstrates seasonal characteristics according to stroke types, ischemic stroke subtypes, risk factors for stroke, and Sasang constitutions. These results have important clinical implications in stroke prevention.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.492-496
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• 2011

Objective : Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. Methods : We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease ($mean{\pm}SD$ age, $37.96{\pm}11.27$ years; range, 18-62 years) who underwent direct bypass surgery over 6 years. Results : Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; $p$=0.001), PCA involvement ($p$=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first ($p$<0.0001) and second ($p$=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. Conclusion : In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.