Stroke Affecting More Middle-Age Patients

A new study suggests that stroke may be shifting from a disease of the elderly to a midlife health concern.

Researchers at the University of Cincinnati (OH, USA) conducted a study to determine temporal trends in stroke incidence (stratified by age) using data from the Greater Cincinnati/Northern Kentucky region, which includes an estimated population of 1.3 million. Strokes were ascertained in the population between July 1, 1993, and June 30, 1994, and in calendar years 1999 and 2005. Age, race, and gender specific incidence rates were calculated assuming distribution and differences in age trends over time were tested using a mixed-model approach, with appropriate link functions.

The results showed that the mean age at stroke significantly decreased from 71.2 years in 1993/1994 to 69.2 years in 2005. The proportion of all strokes under age 55 increased from 12.9% in 1993/1994 to 18.6% in 2005. Stroke incidence rates in those 20-54 years of age were significantly increased in both black and white patients in 2005, compared to earlier periods. The reasons for the incidence trends were not clear, but the researchers suggested it was possible that the trend toward younger stroke was related to changing risk factor prevalence. The study was published early online on October 10, 2012, in Neurology.

“The prevalence of stroke risk factors, including hypertension, diabetes, CHD, and current smoking are all elevated in the younger stroke population compared with the population survey,” concluded lead author Brett Kissela, MD, and colleagues. “This is of great public health significance because strokes in younger patients carry the potential for greater lifetime burden of disability and because some potential contributors identified for this trend are modifiable.”

Stroke risk factors include high blood pressure, cigarette smoking or exposure to secondhand smoke, high cholesterol, diabetes, obesity, physical inactivity, obstructive sleep apnea (OSA), cardiovascular disease (CVD), use of some birth control pills or hormone therapies that include estrogen, heavy or binge drinking, and use of illicit drugs such as cocaine and methamphetamines. Other risk factors include a personal or family history of stroke, heart attack, or transient ischemic attack (TIA), being age 55 or older, race (African-Americans have higher risk of stroke than people of other races), and gender (men have a higher risk of stroke than women).

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