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Nuamah HG, Li Y, Yatsuya H, Yamagishi K, Saito I, Kokubo Y, Muraki I, Iso H, Inoue M, Tsugane S, Sawada N. The effect of age on the relationship between body mass index and risks of incident stroke subtypes: The JPHC study. J Stroke Cerebrovasc Dis 2024; 33:107486. [PMID: 38070372 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/04/2023] [Accepted: 11/13/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The associations between body mass index (BMI) and stroke subtypes, particularly intracerebral hemorrhage, have not been consistent. Such inconsistencies may be due to differences in the age at which BMI was obtained. We examined the possible age modifications in the association between BMI and stroke risk. MATERIALS AND METHODS We followed 88,754 participants, aged 40-69 years at baseline (1990-1994), of the Japan Public Health Center-based prospective (JPHC) study for stroke incidence. BMI was obtained using self-reported body weight and height, which were categorized using the following cut-off points: 18.5, 21, 23, 25, 27.5, and 30 kg/m2. Time-dependent Cox proportional hazards models that updated BMI and covariates using 5- and 10-year questionnaire responses were used to estimate hazard ratios and 95 % confidence intervals. The analyses were stratified by age group (40-59 and ≥60 years) and the age of the individuals was updated. RESULTS During the median follow-up period of 19 years, we documented 4,690 strokes, including 2,781 ischemic strokes and 1,358 intracerebral hemorrhages. After adjusting for sex, age, smoking, alcohol consumption, leisure-time physical activity, history of hypertension, dyslipidemia, and diabetes mellitus, we observed a positive linear association between BMI and ischemic stroke (linear trend, p < 0.001) in both age groups (interaction p>0.05). In contrast, a curvilinear association between BMI and intracerebral hemorrhage was observed in both the middle (curvilinear trend, p=0.017) and the older group (curvilinear trend, p=0.098) (interaction p>0.05). CONCLUSION BMI and stroke associations did not vary significantly with age, although the association may differ according to subtype.
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Affiliation(s)
- Hanson Gabriel Nuamah
- Department of Public Health and Health Systems, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Yuanying Li
- Department of Public Health and Health Systems, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
| | - Kazumasa Yamagishi
- Department of Public Health Medicine and Health Services Research and Development Center, University of Tsukuba, Institute of Medicine, Tsukuba, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Isao Muraki
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan; Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan; International University of Health and Welfare Graduate School of Public Health, Minato-ku, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
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Nuamah HG, Oduro-Mensah E, Oliver-Commey J. Clinical presentation and persistent symptoms in patients at a post-COVID-19 clinic in Ghana. Pan Afr Med J 2023; 45:44. [PMID: 37575521 PMCID: PMC10422034 DOI: 10.11604/pamj.2023.45.44.38778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/30/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction on March 11th, 2020, the World Health Organization recognized COVID-19 as a pandemic. By March 31st, 2021, the Ghana Health Service had recorded a cumulative 90,782 positive cases and 748 deaths in the country. Despite the significant resources and efforts being put into containing and treating individuals with COVID-19, there is a lack of information within sub-Saharan Africa on clinical presentations and factors associated with experiencing persistent symptoms of COVID-19. Methods in this retrospective study, we collected data obtained from patients with COVID-19 who were discharged from the post-COVID-19 clinic at the Ga East Municipal Hospital, Ghana, between April 1st, 2020, and March 31st, 2021, to assess clinical presentations and identify predictors of COVID-19 symptoms that persist beyond 14 days from the onset of the symptom. Results of the 253 patients who experienced symptoms of COVID-19, 81 (32.0%) experienced symptoms that persisted beyond 14 days. Cough (64.0%), headache (38.7%), and chest pain (28.1%) were the most common symptoms. After adjusting for covariates, the odds of patients presenting with COVID-19 symptoms that persist beyond 14 days are 98% higher among patients who experienced chest pain compared to those who did not and 2% increased for each additional year of their age. Conclusion patient´s age and experiencing chest pain were significant predictors of symptoms that persist beyond 14 days. The findings of our study highlight the need to continue to monitor and care for individuals with identified predictors of experiencing persistent symptoms of COVID-19.
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Affiliation(s)
- Hanson Gabriel Nuamah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Ebenezer Oduro-Mensah
- National COVID-19 Treatment Centre, Ga East Municipal Hospital, Ghana Health Service, Kwabenya, Ghana
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