Emerging Non-Hereditary Risk Factors for Stroke

Abstract

Stroke is a leading cause of death and disability globally. The vast majority of all strokes occur in low- and middle-income countries, where data are least available to guide clinical decision-making and health policy. Many strokes are preventable, and established risk factors for stroke are well-known in the scientific literature. However, some risk factors may be less well-recognized but have a particular influence in specific subpopulations. Here, three risk factors for strokes are studied in three separate populations. Fatal stroke in Bangladesh is studied with an emphasis on the potential role of betel nut as a stroke risk factor. Human Immunodeficiency Virus infection and its relationship to stroke, including use of the predictive Framingham Risk Score, is studied in men who have sex with men in the United States. Finally, groundwater arsenic exposure in American Indians is analyzed as a risk factor for carotid artery disease endpoints which are subclinical measurement that directly relate to stroke risk. The relationship between these risk factors and stroke, including their implications for younger-onset stroke, stroke prevention, and advocacy for vascular diseases on the global health agenda are emphasized.