<div id="subtitle">Gender, race make little difference</div><div><p>The more obese you are, the greater your risk of suffering a stroke.</p><p>And, according to a new study published in Stroke: Journal of the American Heart Association, a person's race, gender or how their obesity is measured have nothing to do with it. </p><p>"It has not been clear whether overweight and obesity are risk factors for stroke, especially among blacks," said Hiroshi Yatsuya, M.D., Ph.D., study lead author and visiting associate professor at the University of Minnesota in Minneapolis. "There are also questions about which measure of excess weight (body mass index [BMI], waist circumference or waist-to-hip ratio) is most closely associated with disease risk." </p><p>Analyzing the Atherosclerosis Risk in Communities (ARIC) Study database in which subjects' BMI, waist circumference and waist-to-hip ratio were measured at the study's start, the researchers followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease. </p><p>During the follow-up period of about 19 years, there were 598 strokes. The researchers calculated incidence rate -- the number of new cases per 1,000 people per year -- according to groups representing different degrees of obesity, using each obesity measure. </p><p>They found that incidence rates differed substantially between whites and blacks. For example, the stroke rate in the lowest BMI category was 1.2 per 1,000 person-years for white women and 4.3 per 1,000 person-years for black women. The rate in the highest BMI category was 2.2 for white women and 8.0 for black men. </p><p>"Black women had about three times higher incidence of stroke than white women in the lowest as well as in the highest BMI categories," Yatsuya said. "But the correlation between increasing stroke incidence and increasing degree of obesity was apparent in both races and genders." </p><p>People with the highest BMI had 1.43 to 2.12 times higher risk of stroke compared with the lowest BMI category. When waist circumference was used as a measure of obesity instead of BMI, those risk ratios ranged from 1.65 to 3.19; and 1.69 to 2.55 when waist-to-hip ratio was used. </p><p>Thus, for any obesity measure, individuals in the highest category had approximately two times higher risk of stroke versus the lowest category in each race-sex group. </p><p>"Since individuals with higher degrees of obesity tended to have higher blood pressure levels or higher diabetes prevalence, we further examined the relationship between the degree of obesity and ischemic stroke incidence by statistically adjusting for difference in blood pressure of diabetes status attributed to the degree of obesity," Yatsuya said. "That significantly weakened the associations, suggesting these major risk factors explain much of the obesity-stroke association." </p><p>The link between obesity and stroke is not new. A study presented at the 2008 International Stroke Conference finds risk twice as high in obese middle-aged women. </p><p>This latest study reemphasizes the need to prevent obesity in general, Yatsuya said. But, he said, clinical trials are needed to determine whether obesity prevention or control would actually make a difference.

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