Prevalence of risk factors in acute ischemic cerebrovascular disease (CVD) in elderly patients from eastern sicily

Summary Hundred and forty elderly patients (76 males and 64 females, over 65 years of age) were consecutively admitted to the Institute between November 1989 and April 1993, in order to (i) verify if the risk factors, reported in other Italian areas and regions of the world, are prevalent also in our region, and (ii) outline a secondary prevention strategy against the statistically most important risk factors. There were 111 cases of ischemic stroke (58 males and 53 females) and 29 cases of reversible ischemic attack (RIA) (18 males and 11 females). The percental occurrence of the following risk factors were determined: total cholesterol > 240 mg/dl, HDL cholesterol 180 mg/dl, fibrinogen > 450 mg/dl, hematocrit > 45 %, hypertension, diabetes mellitus, cigarette smoking, familial ischemic events, previous ischemic CVD, ischemic cardiac disease, embolic cardiopathy. In males with ischemic stroke the most frequent risk factors were: hypertension (43 %), fibrinogen > 450 mg/dl (37.9 %), diabetes mellitus, cigarette smoking and previous ischemic CVD (25.8 %). In females with ischemic stroke a clear prevalence of hypertension (69.8 %), ischemic cardiopathy and previous ischemic CVD (47 %) and diabetes meilitus (41.5 %) were observed. In males with RIA hypertension (50 %) and cigarette smoking (38 %). Females with RIA presented a high prevalence of reduced HDL cholesterol, lower than 35 mg/dl (77.7 %), hypertension (63.6 %) and ischemic cardiopathy (54.5 %). The results indicate that there are no highly significant differences between the data reported by other authors on the most important acute ischemic CVD risk factors in Italy and elsewhere. Arterial hypertension and diabetes mellitus are the most important risk factors of cerebral ischemic events in both sexes. The diffusion of cigarette smoking among women in the last thirty years must be taken into consideration. Although it does not represent a risk factor for elderly women today, it may do in the future. Therefore, antismoking campaigns must be more decisive and targeted at both sexes.