Abstract WMP49: Disparities in Rising Incidence of Stroke in Adults Younger Than 65

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Erica Jones ◽  
Kristie Chu ◽  
Anjail Sharrief ◽  
Sean Savitz ◽  
Farhaan Vahidy
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Stroke Risk ◽  
Stroke Incidence ◽  
Stroke In Young Adults ◽  
Hospitalization Rates ◽  
Increased Risk ◽  
Asian Pacific ◽  
Increase In Risk ◽  
Stroke In Young

Introduction: Increased incidence of stroke in young adults has been attributed to rising prevalence of known stroke risk factors such as hypertension. Our aim is to identify young adult demographic groups most in need of clinical and public health intervention to prevent future increases in stroke incidence. Methods: We performed retrospective analyses on hospitalization data from the National Inpatient Sample (NIS) in adults aged 18- 64 years with diagnosis of ischemic stroke, hemorrhagic stroke, or subarachnoid hemorrhage from 2006 to 2015 and compared hospitalization rates over two-year periods. Results: We included data from 1,750,081 hospitalizations meeting inclusion criteria. Comparing 2006-07 to 2014-15, rates of hospitalization for stroke increased significantly across all analyzed gender and racial groups except Asian/Pacific Islanders aged 18-34 and 34-45. Non-Hispanic Blacks (NHB) had the highest stroke hospitalization rates in those aged 18-44, and Asian/Pacific Islander rates were highest in ages 45-64 (Figure 1d,f). In this period, there was a 26% overall increase in risk of hospitalization for stroke in young adults with 42% (CI 1.28 - 1.57) increased risk in women aged 18-34 and 41% (1.32 -1.51) in men aged 35-44. Regionally, the South had the highest incidence of stroke hospitalization in all age groups but the highest increase in risk over the decade was seen in the Northeast. Prevalence of hypertension among hospitalized patients remained unchanged or decreased while prevalence of all other risk factors increased, mostly in obesity and lipid disorders (Figure 1h). Conclusions: Despite public awareness, stroke incidence continues to increase in young patients remaining highest among minorities and in the Southern states, but rising more in the Northeast. Personalized approaches and geographic aspects, in addition to vascular risk factor control, will all likely be needed to reduce stroke risk in these different patient populations.

scholarly journals Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Stroke ◽  
2017 ◽  
Vol 48 (7) ◽  
pp. 1744-1751 ◽  
Author(s):  
Annette Aigner ◽  
Ulrike Grittner ◽  
Arndt Rolfs ◽  
Bo Norrving ◽  
Bob Siegerink ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Stroke Risk ◽  
Stroke Risk Factors ◽  
Stroke In Young Adults ◽  
Stroke In Young

scholarly journals Global Outcome Assessment Life-long after stroke in young adults initiative—the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031144
Author(s):  
Merel Ekker ◽  
Mina Jacob ◽  
Myrna van Dongen ◽  
Karoliina Aarnio ◽  
Arunkar Annamalai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Secondary Prevention ◽  
Stroke Risk ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Stroke Patients ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young

IntroductionWorldwide, 2 million patients aged 18–50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.Methods and analysisThe Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18–50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Ethics and disseminationEthical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.

scholarly journals Cerebrovascular Disease in the Young Adult: Examining Melatonin’s Possible Multiple Roles

2019 ◽  
Vol 13 ◽  
pp. 117906951982730 ◽  
Author(s):  
Adejoke Yetunde Onaolapo ◽  
Olakunle James Onaolapo ◽  
Thomas I Nathaniel
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Young Adult ◽  
Animal Studies ◽  
Neuronal Damage ◽  
Well Being ◽  
Stroke In Young Adults ◽  
Stroke Population ◽  
Increased Risk ◽  
Stroke In Young

In the last decade or more, there have been reports suggesting a rise in the incidence of stroke in young adults. Presently, it appears that the risk factors associated with the cause of stroke in young adults remain relatively constant across different geographic regions of the world. Moreover, the endogenous rhythm of a neurohormone such as melatonin is known to play certain roles in the modulation of some of the risk factors that are associated with an increased risk of stroke in young people. Whereas animal studies have shown that melatonin plays diverse roles in stroke, only a limited number of human studies examined the roles of exogenous melatonin administration in the prevention of stroke, attenuation of neuronal damage, and improving outcome or well-being in stroke patients. In this review, first we summarize existing studies of stroke in the young adult and then provide insights on melatonin and stroke. Thereafter, we discuss the role of melatonin in models of stroke and how melatonin can be regulated to prevent stroke in young adults. Finally, we highlight the possible roles of melatonin in the management and outcome of stroke, especially in the young adult stroke population.

Abstract P672: Black White Disparity in Multiple Risk Factors is Increased in Older Young Adults

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Prachi Mehndiratta ◽  
Kathleen Ryan ◽  
Adeolu Morawo ◽  
Seemant Chaturvedi ◽  
Carolyn A Cronin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Stroke Risk ◽  
Reference Group ◽  
Population Based ◽  
Multiple Risk Factors ◽  
Stroke In Young Adults ◽  
Multiple Risk ◽  
The Relationship ◽  
Control Study

Background: Stroke in young adults constitutes 15-18% of all ischemic strokes. Vascular risk factors contribute to stroke risk in young adults particularly older young adults. Few studies have addressed Black White differences in risk, stratified by age. We evaluated the prevalence of risk factors in the younger young (less than 40 years) vs. the older young adults (40 and above). Methods: A population based case control study with 1034 cases and 1091 controls, ages 15-49 was used to investigate the relationship between risk factors (DM, HTN, Smoking and Obesity) and stroke. Groups were defined by the number of risk factors (RF) among cases and controls : no risk factors (ref group), one RF, two RF, three RF and four RF. Prevalence of risk factors was determined in the entire population and stratified by age, sex and race. Logistic regression was used to determine odds of stroke based on the number of risk factors compared to the reference group. Results: The percent of cases with three or more risk factors was compared in different subgroups: ages 15-39 vs. 40-49 was 8.4 vs. 21.6, women vs. men was 15.6 vs. 18.6 and White vs. Black was 12.3 vs. 22.7. Among cases 40 years and older, Blacks were 3 times more likely than Whites (5.9 vs. 2) to have four or more risk factors.Across all age, race and sex subgroups, the odds of having a stroke increased exponentially with an increase in the number of risk factors. Conclusion: Blacks are more likely to have multiple risk factors than Whites. This difference is accentuated in those 40 years and older. Targeting young adults with multiple risk factors for preventive interventions would address a root case of excess stroke risk especially among Blacks.

Abstract WMP53: Traditional Vascular Risk Factors Account for Different Proportions of Ischemic Stroke Within Different Gender and Race Groups

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Elizabeth M Aradine ◽  
Yan Hou ◽  
Kathleen A Ryan ◽  
Prachi Mehndiratta ◽  
Michael S Phipps ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Black Men ◽  
White Men ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Odds Ratios ◽  
Stroke In Young Adults ◽  
Stroke In Young

Introduction: Few studies have compared the proportion of ischemic strokes attributable to traditional vascular risk factors (population-attributable risk percent or PAR%) between genders and races. The PAR% is a function of the population prevalence and strength of association of a risk factor. Methods: A population-based case-control study of ischemic stroke in young adults ages 18-49 in the Baltimore-Washington region was used to study the prevalence, odds ratios, and PAR% of hypertension, diabetes, and smoking among blacks and whites. Logistic regression was used to calculate age-adjusted odds ratios. All analyses were stratified by gender. Results: There were 1044 cases and 1099 controls. Of the cases, 47% were black, 54% were women. Roughly a quarter to a third of all strokes in women were attributable to smoking. Due to the higher prevalence of hypertension and a higher odds ratio for hypertension in black men (OR 3.9, 95% CI 2.6-5.9) compared to white men (OR 1.8, 95% CI 1.3-2.6), there was a much higher PAR% for hypertension among black men than white men. See Table 1 for prevalence and Table 2 for PAR% stratified by gender and race. Conclusion: Traditional vascular risk factors have the potential to explain a high proportion of ischemic stroke in young adults. The high proportion of strokes in women attributable to smoking underscores the need for targeted smoking cessation interventions in this population. Diabetes and, especially, hypertension are important contributors to the excess population burden of ischemic stroke among blacks. These findings support the value of early screening and treatment for hypertension in young blacks.

Young Adult with Headache and Blurred Vision

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Young Adult ◽  
Vascular Risk ◽  
High Cholesterol ◽  
Blurred Vision ◽  
Younger Patients ◽  
Stroke In Young Adults ◽  
Extensive Evaluation ◽  
Stroke In Young

Traditional vascular risk factors such as hypertension, diabetes, and high cholesterol can contribute to stroke in young adults. In the absence of typical risk factors in a young patient, a more extensive evaluation is needed. Other, more unusual causes of stroke can include autoimmune, infectious, hematological, and toxic etiologies. Often, despite an exhaustive workup, the mechanism of stroke remains cryptogenic in younger patients.

Ischaemic stroke in young adults: risk factors and long-term consequences

2014 ◽  
Vol 10 (6) ◽  
pp. 315-325 ◽  
Author(s):  
Noortje A. M. M. Maaijwee ◽  
Loes C. A. Rutten-Jacobs ◽  
Pauline Schaapsmeerders ◽  
Ewoud J. van Dijk ◽  
Frank-Erik de Leeuw
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischaemic Stroke ◽  
Stroke In Young Adults ◽  
Long Term Consequences ◽  
Stroke In Young

scholarly journals Stroke incidence and association with risk factors in women: a 32-year follow-up of the Prospective Population Study of Women in Gothenburg

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005173 ◽  
Author(s):  
Ann Blomstrand ◽  
Christian Blomstrand ◽  
Nashmil Ariai ◽  
Calle Bengtsson ◽  
Cecilia Björkelund
Keyword(s):  
Risk Factors ◽  
Population Study ◽  
Physical Inactivity ◽  
Stroke Risk ◽  
Diastolic Pressure ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Increased Risk ◽  
Low Education ◽  
High Bmi

ObjectiveTo study stroke incidence among women over 32 years of age with a focus on subdividing by stroke type, to consolidate end points and associations with risk factors.DesignProspective population study initiated in 1968–1969 with follow-ups in 1974, 1980, 1992 and 2001.SettingGothenburg, Sweden.ParticipantsA sample of 1462 women from five age strata examined in 1968–1969, representative of women in the general population.Main outcome measuresMain types of first-ever stroke and fatal stroke during 1968–2001 identified and validated. Stroke incidence rates in different age strata. Association with baseline smoking, body mass index (BMI), waist–hip ratio, hypertension, serum lipids, physical inactivity, perceived mental stress and education. Associations with atrial fibrillation (AF), diabetes, baseline hypertension and myocardial infarction (MI). Blood pressure (BP) levels 1–3, corresponding to modern guidelines, in relation to stroke risk.Results184 (12.6%) cases of first-ever stroke, 33 (18%) of them fatal. Validation reduced unspecified stroke diagnoses from 37% to 11%. Age-standardised incidence rate per 100 000 person-years was 448. A multivariate model showed a significant association between ischaemic stroke and high BMI: HR 1.07 (95% CI 1.02 to 1.12), smoking 1.78 (1.23 to 2.57) and low education 1.17 (1.01 to 1.35). Significant association was seen between haemorrhagic stroke and, besides age, physical inactivity 2.18 (1.04 to 4.58) and for total stroke also hypertension 1.45 (1.02 to 2.08). Survival analysis showed a significantly increased risk of stroke in participants with diabetes (p<0.001), AF (p<0.001) and hypertension (p=0.001), but not MI. Stroke risk increased with increasing BP levels but was already seen for diastolic pressure grade 1 and particularly when combined with systolic BP grade 1; 1.62 (1.17 to 2.25).ConclusionsHypertension, smoking, AF, diabetes and high BMI were associated with increased stroke risk. Low education was associated with stroke. Validation of National Patient Registry diagnoses to increase specified diagnoses improved data quality.

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