Predictors of stroke mortality in elderly people from the general population - The CArdiovascular STudy in the ELderly

Stroke occurs particularly frequently in elderly people and, being more often disabling than fatal, entails a high social burden. The predictors of stroke mortality have been identified in 3282 subjects aged P years, taking part in the CArdiovascular STudy in the ELderly (CASTEL), a population-based study performed in Northeast Italy. Historical and clinical data, blood tests and 14-year fatal events were recorded. Continuous items were divided into quintiles and, for each quintile, adjusted relative risk (RR) with 95% confidence intervals [CI] was derived from multivariate Cox analysis. Age, historical stroke (RR: 5.2; 95% CI: 3.18-8.6) and coronary artery disease ( RR: 1.38; CI: 1.18-2.1), atrial fibrillation (RR: 2.40; CI: 1.42-4.0), arterial hypertension (RR:1.33; CI: 1.15 1.76), systolic blood pressure greater than or equal to163 mmHg (RR: 1.84; CI: 1.20-2.59), pulse pressure greater than or equal to74 mmHg (RR: 1.50; CI: 1.13-2.40), cigarette smoking (RR: 1.60; CI: 1.03-2.47), electrocardiographic left ventricular hypertrophy (RR: 1.72; CI: 1.10-2.61), impaired glucose tolerance (IGT, RR: 1.83; CI: 1.10-3.0), uric acid (UA) > 0.38 mmol/ l (RR: 1.61; CI: 1.14-2.10), serum potassium greater than or equal to5 mEq/l (RR: 1.70; CI: 1.24-2.50) and serum sodium less than or equal to139 mEql/l ( RR: 1.34; 1.10-2.10) increased the risk of stroke. In the CASTEL, stroke was the first cardiovascular cause of death. Some independent predictors usually unrelated to stroke mortality ( namely pulse pressure, pre-diabetic IGT, UA and blood electrolytes disorders) have been identified.