Obesity among African-American stroke survivors increases risk factors for recurrent stroke

March 14, 2005

CHICAGO - Obesity may put African-Americans who have survived one stroke at risk for a second stroke by increasing their risk of hypertension (high blood pressure), diabetes and high cholesterol, according to an article in the March issue of Archives of Neurology, one of the JAMA/Archives journals.

Obesity has become epidemic in the United States and African-Americans have the highest rate of obesity, nearly 40 percent, as reported in the 1999-2000 National Health and Nutritional Examination Survey (NHANES), according to background information in the article. Obesity is associated with a number of negative health consequences, including insulin resistance, hypertension, dyslipidemia (high cholesterol levels or other lipid level problems), stroke, coronary artery disease and decreased life expectancy.

Sean Ruland, D.O., of the University of Illinois at Chicago, and colleagues analyzed data from African-American patients enrolled in a study of treatment for prevention of stroke recurrence (the African-American Antiplatelet Stroke Prevention Study [AAASPS]) to determine the association between obesity and cardiovascular risk factor profiles for African-American stroke survivors. Using baseline data on height and weight, the researchers determined the body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) for 1,711 patients. The patients were divided into six groups, underweight (BMI less than 18.5), normal weight (BMI 18.5 - 24.9), overweight ((BMI 25.0 - 29.9), class one obesity (BMI 30.0 - 34.9), class two obesity (BMI 35.0 - 39.9) and class three obesity (BMI greater than 40.0).

The researchers compared patients' BMI with the cardiovascular risk factors, hypertension (HTN), diabetes mellitus (DM) and dyslipidemia (DL). Overall, 76 percent of the patients (70 percent of men and 81 percent of women) were overweight or obese. Nearly 20 percent of women younger than 55 years and 7.0 percent of men in that age group qualified as class three obese.

Presence of diabetes mellitis increased with increasing BMI for both men and women. Although the proportion of patients with hypertension was high for all weight categories, blood pressure also increased with increased BMI, although more modestly. The proportion with dyslipidemia increased with increasing BMI for men, but not for women. In this study, the authors defined metabolic syndrome as the presence of obesity, hypertension, diabetes and dyslipidemia, and found that the three risk factors (hypertension, dyslipidemia and diabetes) were present in 26.1 percent of men and 34.7 percent of women with class one obesity, in 29.4 percent of men and 31.3 percent of women with class two obesity and in 43.3 percent of men and 29.1 percent of women with class three obesity. Metabolic syndrome increases cardiovascular risk more than any of the individual factors which comprise it.

"A metabolic syndrome was seen in 21 percent of men and 29 percent of women in the AAASPS," the authors write. 'Although BMI was not an independent predictor of stroke occurrence, obesity nearly doubled the odds of having a metabolic syndrome compared with the odds of those with a normal BMI having DM, HTN and DL. Furthermore, increasing BMI had a negative association with blood pressure and glycemic [blood sugar] control."

"Our data support the association of increasing risk factor profiles and decreasing risk factor control with increasing weight," the authors conclude. "This is particularly important in African American stroke survivors, as this group has been shown to have a worse risk factor profile than their non-African-American counterparts, putting them at high risk for recurrent stroke. Furthermore, the high morbidity [illness] and mortality [death] due to stroke in African-Americans should make this an increasing area of public health concern."
-end-
(Arch Neurol. 2005; 62:386-390. Available post-embargo at www.archneurol.com.)

Editor's Note: This study was supported in part by a grant from the National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, Md.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or email mediarelations@jama-archives.org.

The JAMA Network Journals

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.