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How Much Can Be Explained by Risk Factors?

Domenico Inzitari, MD; Vladimir C. Hachinski, MD, MSc, DSc; D. Wayne Taylor, MSc; Henry J. M. Barnett, OC, MD

Arch Neurol. 1990;47(10):1080-1084.

Abstract
• The entry characteristics of 1367 patients enrolled into the Extracranial/Intracranial Bypass Study were examined to determine if site differences in intracranial and extracranial arterial lesions among racial groups could be explained by differences in risk factors. Blacks were more often hypertensive, diabetic, or cigarette smokers, while whites had higher systolic blood pressure and hemoglobin values. Orientals had the lowest prevalence of vascular risk factors. Despite these differences in risk factors, multivariate analysis showed race to be an independent and strong predictor of the location of cerebrovascular lesions. To our knowledge, this study is unique in documenting risk factors prospectively and systematically in three racial groups simultaneously. Although generalization is limited by possible biases related to patient selection, the results affirm previous tentative conclusions about the role of race in determining the location of cerebrovascular disease.

Author Affiliations
From the Department of Neurology, University of Florence (Italy) Medical School (Dr Inzitari); Department of Clinical Neurological Sciences, The University of Western Ontario, London (Dr Hachinski); The John P. Robarts Research Institute, London, Ontario (Drs Hachinski and Barnett, and Prof Taylor); and the Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Prof Taylor).

Footnotes
Accepted for publication March 26, 1990.

Reprint requests to the Department of Clinical Neurological Sciences, University Hospital, PO Box 5339, London, Ontario, Canada N6A 5A5 (Dr Hachinski).

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