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J Epidemiol Community Health. 1991 June; 45(2): 138–142.
PMCID: PMC1060731

Overweight and stroke in the Whitehall study.


STUDY OBJECTIVE--The aim was to examine the risk of increasing overweight for death from stroke. DESIGN--This was a prospective cohort study, in which the main outcome measure was the mortality ratio for stroke with increasing body mass index. SETTING--Civil service departments, Whitehall, London. SUBJECTS--Participants were 17,753 men aged 40 to 64 years. MEASUREMENTS AND MAIN RESULTS--208 stroke deaths were recorded. Men aged 40 to 54 in the most overweight quintile of body mass index had a mortality ratio of 2.01 (95% confidence interval 0.9 to 4.7) compared to the thinnest quintile. The mortality ratio was 1.19 (95% CI 0.7 to 2.0) in men aged 55 to 64. The increase in risk was more apparent in non-smokers: age adjusted mortality ratio 2.58 (95% CI 1.2 to 5.7). When smoking status and overweight were considered in combination a gradient of the age adjusted mortality ratio was observed, from 1.0 in thinner/non-smokers up to 3.15 in fatter/current smokers. On the assumption that smoking and obesity cause strokes, an estimated 60% of strokes could be prevented if these two easily identifiable risk factors could be avoided. CONCLUSIONS--The risks of overweight for death from stroke were more apparent in younger subjects and non-smokers. A substantial proportion of stroke deaths occurring under the age of 80 years would probably be prevented if cigarette smoking and overweight could be avoided.

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Selected References

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  • Ostfeld AM. A review of stroke epidemiology. Epidemiol Rev. 1980;2:136–152. [PubMed]
  • Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983 May;67(5):968–977. [PubMed]
  • Fuller JH, Shipley MJ, Rose G, Jarrett RJ, Keen H. Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):867–870. [PMC free article] [PubMed]
  • Vandenbroucke JP. Should we abandon statistical modeling altogether? Am J Epidemiol. 1987 Jul;126(1):10–13. [PubMed]
  • Lee J. An insight on the use of multiple logistic regression analysis to estimate association between risk factor and disease occurrence. Int J Epidemiol. 1986 Mar;15(1):22–29. [PubMed]
  • Shinton R, Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989 Mar 25;298(6676):789–794. [PMC free article] [PubMed]
  • Reid DD, Brett GZ, Hamilton PJ, Jarrett RJ, Keen H, Rose G. Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention. Lancet. 1974 Mar 23;1(7856):469–473. [PubMed]
  • Paffenbarger RS, Jr, Wing AL. Chronic disease in former college students. XI. Early precursors of nonfatal stroke. Am J Epidemiol. 1971 Dec;94(6):524–530. [PubMed]
  • Paffenbarger RS, Jr, Wing AL. Characteristics in youth predisposing to fatal stroke in later years. Lancet. 1967 Apr 8;1(7493):753–754. [PubMed]
  • Herman B, Leyten AC, van Luijk JH, Frenken CW, Op de Coul AA, Schulte BP. An evaluation of risk factors for stroke in a Dutch community. Stroke. 1982 May-Jun;13(3):334–339. [PubMed]
  • Rhoads GG, Kagan A. The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet. 1983 Mar 5;1(8323):492–495. [PubMed]
  • Welin L, Svärdsudd K, Wilhelmsen L, Larsson B, Tibblin G. Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med. 1987 Aug 27;317(9):521–526. [PubMed]
  • Tanaka H, Ueda Y, Hayashi M, Date C, Baba T, Yamashita H, Shoji H, Tanaka Y, Owada K, Detels R. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke. 1982 Jan-Feb;13(1):62–73. [PubMed]
  • Paganini-Hill A, Ross RK, Henderson BE. Postmenopausal oestrogen treatment and stroke: a prospective study. BMJ. 1988 Aug 20;297(6647):519–522. [PMC free article] [PubMed]
  • Khaw KT, Barrett-Connor E, Suarez L, Criqui MH. Predictors of stroke-associated mortality in the elderly. Stroke. 1984 Mar-Apr;15(2):244–248. [PubMed]
  • Petitti DB, Wingerd J, Pellegrin F, Ramcharan S. Risk of vascular disease in women. Smoking, oral contraceptives, noncontraceptive estrogens, and other factors. JAMA. 1979 Sep 14;242(11):1150–1154. [PubMed]
  • Semenciw RM, Morrison HI, Mao Y, Johansen H, Davies JW, Wigle DT. Major risk factors for cardiovascular disease mortality in adults: results from the Nutrition Canada Survey cohort. Int J Epidemiol. 1988 Jun;17(2):317–324. [PubMed]
  • Abu-Zeid HA, Choi NW, Maini KK, Hsu PH, Nelson NA. Relative role of factors associated with cerebral infarction and cerebral hemorrhage. A matched pair case-control study. Stroke. 1977 Jan-Feb;8(1):106–112. [PubMed]
  • Ostfeld AM, Shekelle RB, Klawans H, Tufo HM. Epidemiology of stroke in an elderly welfare population. Am J Public Health. 1974 May;64(5):450–458. [PubMed]
  • Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjöström L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984 Nov 10;289(6454):1257–1261. [PMC free article] [PubMed]
  • Heyden S, Hames CG, Bartel A, Cassel JC, Tyroler HA, Cornoni JC. Weight and weight history in relation to cerebrovascular and ischemic heart disease. Arch Intern Med. 1971 Dec;128(6):956–960. [PubMed]
  • Donnan GA, McNeil JJ, Adena MA, Doyle AE, O'Malley HM, Neill GC. Smoking as a risk factor for cerebral ischaemia. Lancet. 1989 Sep 16;2(8664):643–647. [PubMed]
  • Colditz GA, Bonita R, Stampfer MJ, Willett WC, Rosner B, Speizer FE, Hennekens CH. Cigarette smoking and risk of stroke in middle-aged women. N Engl J Med. 1988 Apr 14;318(15):937–941. [PubMed]

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