Striking a Path for Canada-India Collaborations

Yesterday, I spoke at the clinical pre-conference of the Canada-India Networking Initiative on Cardiovascular Health: Opportunities and Challenges for Collaboration Between Canada and India.

The four-day conference, hosted by Simon Fraser University and Fraser Health, is being held at the Kwantlen Polytechnic University in Surrey, BC.

The conference was opened by the Hon. Moira Stilwell, BC’s Minister of Advanced Education and Labour Market Development, who emphasized the importance of fostering these type of international collaborations to improve the health of citizens of both nations.

I am certainly most grateful to Arun Chockalingam (former member of the Board of Directors of the Canadian Obesity Network) and Arun Garg, co-organisers of this meeting, for the opportunity to participate in this event.

Also on the program of this conference are the results of INTERSTROKE, a massive international collaboration of Canada-based researchers (led by McMaster University’s Salim Yusuf) with colleagues from around the world, including India, published online yesterday in The Lancet.

Regular readers of these pages may recall the results of the INTERHEART study, which demonstrated the importance of abdominal obesity (among other factors) for heart disease.

The just published INTERSTROKE study is a case-control study in 22 countries worldwide between comparing patients with acute first stroke (n=3000) to age and sex-matched controls with no history of stroke (n=3000).

The researchers identified 10 risk factors that together account for almost 90% of the risk for ischaemic and haemorrhagic stroke).

Abdominal obesity, expressed as the highest tertile of waist-to-hip ratio, was associated with a 1.65-fold increase for stroke.

The other significant risk factors included history of hypertension (OR 2·64), current smoking (2·09), diet risk score (1·35), regular physical activity (0·69), diabetes mellitus (1·36), more than 30 drinks per month or binge drinking (1·51), psychosocial stress (1·30) and depression (1·35), cardiac causes (2·38), and ratio of apolipoproteins B to A1 (1·89).

Collectively, these risk factors accounted for 88·1% of the population attributable risk for all stroke.

These risk factors were all significant for ischaemic stroke, whereas hypertension, smoking, waist-to-hip ratio, diet, and alcohol intake were significant risk factors for intracerebral haemorrhagic stroke.

Within food groups, intake of fish and fruits—components of a Mediterranean diet – was associated with the greatest risk reduction.

Surrey, British Columbia

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