Leukocyte count, diabetes mellitus and age are strong predictors of strokein a rural population in southern Italy: an 8-year follow-up

Stroke incidence rates in the Mediterranean area are higher compared to nor thern European countries. In this study, we present the 8-year prospective data from a small rural Sicilian town. This population, consisting of 1351 subjects (622 males and 729 females), is homogeneous for ethnic background with traditional healthy dietary habits and shows low cholesterol mean leve ls. We found that the risk of stroke was significantly associated with the record of at least one previous neurological symptom (PNS), such as lack of strength, loss of vision or speech or possible drop attacks, and high hema tocrit in males, and to high body mass index (BMI) and waist-hip ratio (WHR ), diabetes, hypertension, high leukocyte count in females. We also documen ted age-related differences: stroke was associated in younger subjects (age < 65 years) with diabetes, high BMI, high uric acid levels and in older pa tients (age <greater than or equal to> 65 years) with high WHR, hypertensio n, diabetes, PNS, leukocyte count and hematocrit above the 95th percentile. Multivariate analysis demonstrated an independent association between stro ke and age, diabetes, leukocyte count, hypertension and PNS. In conclusion, in this rural Sicilian population, the incidence rate of stroke is 1.72 ca ses per 1000/year in the subjects between 40 and 75 years of age. The risk factors associated with stroke are different in younger and older subjects. Leukocyte count, as an expression of an undergoing inflammatory process, m ay have a relevant role at least in the elderly. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.