Evidence map›Paper›PMID 25628306›Full record

ArticleStroke2015

Adherence to a Mediterranean diet and prediction of incident stroke.

Georgios Tsivgoulis, Theodora Psaltopoulou, Virginia G Wadley, Andrei V Alexandrov, George Howard, Frederick W Unverzagt, Claudia Moy, Virginia J Howard, Brett Kissela, Suzanne E Judd

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 8 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 8 syntheses or guidelines pooled it, 85 citations in OpenAlex.

  1. Pooled it
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  8. Meta-Analysis of Potassium Intake and the Risk of Stroke.Journal of the American Heart Association · 2016
    Pooled it
  9. Trial
  10. Trial
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  16. Observational
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  18. Eating Behaviors, Lifestyle, and Ischemic Stroke: A Lebanese Case-Control Study.International journal of environmental research and public health · 2023
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Georgios TsivgoulisFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.). tsivgoulisgiorg@yahoo.gr.
Theodora PsaltopoulouFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Virginia G WadleyFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Andrei V AlexandrovFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
George HowardFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Frederick W UnverzagtFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Claudia MoyFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Virginia J HowardFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Brett KisselaFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
Suzanne E JuddFrom the Second Department of Neurology, Attikon Hospital (G.T.) and Department of Hygiene, Epidemiology and Medical Statistics (T.P.), University of Athens School of Medicine, Athens, Greece; Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN (G.T., A.V.A.); International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.); Department of Medicine (V.G.W.), Department of Biostatistics, School of Public Health (G.H., S.E.J.), and Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry, Indiana University School of Medicine, Indianapolis (F.W.U.); National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (C.M.); and Department of Neurology, University of Cincinnati, OH (B.K.).
University of Tennessee Health Science Center · USIndiana University School of MedicineNational Institute of Neurological Disorders and Stroke · USUniversity of Alabama at Birmingham · USNational Institutes of Health · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
LCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5M
Cincinnati Center for Clinical and Translational Sciences and TrainingUL1TR000077 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E. · 2012 to 2014
$9.9M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsR01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARY CUSHMAN, VIRGINIA J. HOWARD · 2001 to 2026
$8.8M
NCATS NIH HHS UL1 TR000077NCATS NIH HHS UL1 TR001425NINDS NIH HHS R01 NS041588NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

background and purposeThere are limited data on the potential association of adherence to Mediterranean diet (MeD) with incident stroke. We sought to assess the longitudinal association between greater adherence to MeD and risk of incident stroke.

methodsWe prospectively evaluated a population-based cohort of 30 239 individuals enrolled in REasons for Geographic and Racial Differences in Stroke (REGARDS) study, after excluding participants with stroke history, missing demographic data or food frequency questionnaires, and unavailable follow-up information. Adherence to MeD was categorized using MeD score. Incident stroke was adjudicated by expert panel review of medical records during a mean follow-up period of 6.5 years.

resultsIncident stroke was identified in 565 participants (2.8%; 497 and 68 cases of ischemic stroke [IS] and hemorrhagic stroke, respectively) of 20 197 individuals fulfilling the inclusion criteria. High adherence to MeD (MeD score, 5-9) was associated with lower risk of incident IS in unadjusted analyses (hazard ratio, 0.83; 95% confidence interval, 0.70-1.00; P=0.046). The former association retained its significance (hazard ratio, 0.79; 95% confidence interval, 0.65-0.96; P=0.016) after adjustment for demographics, vascular risk factors, blood pressure levels, and antihypertensive medications. When MeD was evaluated as a continuous variable, a 1-point increase in MeD score was independently associated with a 5% reduction in the risk of incident IS (95% confidence interval, 0-11%). We documented no association of adherence to MeD with incident hemorrhagic stroke. There was no interaction of race (P=0.37) on the association of adherence to MeD with incident IS.

conclusionsHigh adherence to MeD seems to be associated with a lower risk of incident IS independent of potential confounders. Adherence to MeD is not related to the risk of incident hemorrhagic stroke.

Indexed as

Diet, MediterraneanPatient ComplianceAgedAnthropometryEthnicityFemaleFollow-Up StudiesHumansIncidenceLongitudinal StudiesMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk FactorsStrokediet, Mediterraneanhemorrhagic disorderspatient adherencestroketransient ischemic attack

Identifiers

PMID25628306
PMCPMC4621211
OpenAlexW2132129817

What Socratic holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.