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Soderholm M.,Lund University | Soderholm M.,Skane University Hospital | Zia E.,Lund University | Zia E.,Skane University Hospital | And 3 more authors.
Stroke | Year: 2012

BACKGROUND AND PURPOSE-: The etiology of subarachnoid hemorrhage (SAH) is poorly understood. Reduced lung function, expressed as low forced expiratory volume in 1 second (FEV1) and low forced vital capacity (FVC), is a predictor of cardiovascular disease, but whether reduced lung function is a risk factor for SAH is not known. The association between lung function and incidence of SAH was investigated in a prospective cohort study. METHODS-: Between 1974 and 1992, 20 534 men and 7237 women (mean age, 44 years) were examined in a health screening program including spirometry. The incidence of SAH was studied during a mean follow-up of 26 years in relation to age- and height-standardized FEV1, FVC, and FEV1/FVC. RESULTS-: One hundred forty-five subjects had a SAH (18.3 per 100 000 person-years in men and 26.5 per 100 000 person-years in women). The hazard ratio for SAH in the lowest compared to the highest quartile of FEV1 and FEV1/FVC was 2.24 (95% CI, 1.32-3.81; P for trend=0.014) and 1.92 (95% CI, 1.14-3.23; P for trend=0.003), respectively, after adjustment for several confounding factors including smoking and hypertension. The results persisted when analysis was restricted to nonsmokers. FVC showed no significant association with incidence of SAH. CONCLUSIONS-: Baseline lung function, expressed as low FEV1 or FEV1/FVC, is a risk factor for SAH, independently of smoking. © 2012 American Heart Association, Inc.

Oudin A.,Umea University | Jakobsson K.,Umea University | Stroh E.,Umea University | Lindgren A.G.,Lund University | And 5 more authors.
Cerebrovascular Diseases | Year: 2011

Background: The aim was to investigate whether the effects of major risk factors for ischemic stroke were modified by long-term exposure to air pollution in Scania, southern Sweden. Methods: Cases were defined as first-ever ischemic strokes in patients born between 1923 and 1965 during 2001-2006 (n = 7,244). Data were collected from The Swedish National Stroke Register (Riks-stroke) and the Malmö and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NOx concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NO x categories was tested for smoking, hypertension, diabetes mellitus, atrial fibrillation and physical inactivity. Data were analyzed as case-control data and to some extent as case-only data, with logistic regression analysis. Results: The case-control odds ratios for ischemic stroke in association with diabetes were 1.3 [95% confidence interval (CI): 1.1-1.6] and 2.0 (95% CI: 1.2-3.4) in the lowest and highest NOx category, respectively (p value for testing heterogeneity across the categories = 0.056). The case-only approach gave further support for the risk associated with diabetes to increase with NOx (p for trend = 0.033). We observed no main effect of mean NOx or any conclusive effect modifications between NOx and smoking, hypertension, atrial fibrillation or physical inactivity. Conclusions: In a low-level air pollution area, the risk for ischemic stroke associated with diabetes seemed to increase with long-term exposure to air pollution. Copyright © 2010 S. Karger AG, Basel.

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