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Abstract
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends
on the specific pathogenesis of stroke. Risk factors for stroke can be categorized
as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk
factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet,
and physical inactivity are among some of the more commonly reported modifiable risk
factors. More recently described risk factors and triggers of stroke include inflammatory
disorders, infection, pollution, and cardiac atrial disorders independent of atrial
fibrillation. Single-gene disorders may cause rare, hereditary disorders for which
stroke is a primary manifestation. Recent research also suggests that common and rare
genetic polymorphisms can influence risk of more common causes of stroke, due to both
other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic
factors, particularly those with environmental interactions, may be more modifiable
than previously recognized. Stroke prevention has generally focused on modifiable
risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking
cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular
diseases. Other prevention strategies include identifying and treating medical conditions,
such as hypertension and diabetes, that increase stroke risk. Recent research into
risk factors and genetics of stroke has not only identified those at risk for stroke
but also identified ways to target at-risk populations for stroke prevention.
[1
]Department of Epidemiology, Mailman School of Public Health, Columbia University,
New York, NY
[2
]Department of Neurology, College of Physicians and Surgeons, Columbia University,
New York, NY
Author notes
Address for correspondence: Mitchell S. Elkind, MD, Neurological Institute, 710 West
168
th Street, New York, NY 10032, Tel: 212 305-1710; Fax: 212 305-1658