PREVALENCE OF RISK-FACTORS IN ACUTE ISCHEMIC CEREBROVASCULAR-DISEASE (CVD) IN ELDERLY PATIENTS FROM EASTERN SICILY

Hundred and forty elderly patients (76 males and 64 females, over 65 y ears of age) were consecutively admitted to the Institute between Nove mber 1989 and April 1993, in order to (i) verify if the risk factors, reported in other Italian areas and regions of the world, are prevalen t 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 re versible ischemic attack (RIA) (18 males and 11 females). The percenta l occurrence of the following risk factors were determined: total chol esterol > 240 mg/dl, HDL cholesterol < 35 mg/dl, triglycerides > 180 m g/dl, fibrinogen > 450 mg/dl, hematocrit > 45 %, hypertension, diabete s mellitus, cigarette smoking, familial ischemic events, previous isch emic 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 smo king and previous ischemic CVD (25.8 %). in females with ischemic stro ke a clear prevalence of hypertension (69.8 %), ischemic cardiopathy a nd previous ischemic CVD (47 %) and diabetes mellitus (41.5 %) were ob served. In males with RIA hypertension (50 %) and cigarette smoking (3 8 %). Females with RIA presented a high prevalence of reduced HDL chol esterol, lower than 35 mg/dl (77.7 %), hypertension (63.6 %) and ische mic cardiopathy (54.5 %). The results indicate that there are no highl y significant differences between the data reported by other authors o n the most important acute ischemic CVD risk factors in Italy and else where. Arterial hypertension and diabetes mellitus are the most import ant risk factors of cerebral ischemic events in both sexes. The diffus ion 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, antismok ing campaigns must be more decisive and targeted at both sexes.