U.S. Stroke Patients Are Getting Younger

Study found rise in rates among adults aged 20 to 54

Wednesday, October 10, 2012

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WEDNESDAY, Oct. 10 (HealthDay News) -- U.S. stroke patients tend to be younger today than they were in the 1990s, a new analysis reveals.
Specifically, researchers found that while stroke patients between the ages of 20 and 54 made up nearly 13 percent of all stroke patients in 1993 and 1994, that figure rose to just shy of 19 percent by 2005.
The result: In the interim, the average age at which strokes now occur has dropped significantly, down from roughly 71 years old in the mid-1990s to about 69 a decade later.
"This is pretty important, and a pretty big jump," said study lead author Dr. Brett Kissela, professor and vice chairman of neurology at the University of Cincinnati College of Medicine. "And what it means is that even though young people typically feel like they're healthy and that a stroke can't happen to them, the fact is that our study is evidence that that is not true."
Kissela and his colleagues discuss their observations in the Oct. 10 online issue of the journal Neurology.
According to the American Stroke Association, strokes are a major cause of disability, and now the fourth leading cause of death in the United States.
To get a sense of how stroke incidence has been trending, the authors analyzed data concerning first-time stroke patients residing in the greater Cincinnati/Northern Kentucky region, home to roughly 1.3 million men and women.
Stroke snapshots were taken in 1993 and 1994, and again in 1999 and 2005.
After comparing the three periods, the team concluded that strokes among young and middle-aged adults account for a larger piece of the puzzle today than they did before.
What's more, the observed trend appeared to apply to young people across the board, regardless of race. For example, the team noted that what had been 83 strokes for every 100,000 young black residents in 1993 and 1994 rose to 128 strokes per 100,000 by 2005. Similarly, among young white residents those figures rose from 26 strokes per 100,000 in the 1990s to 48 per 100,000 by 2005.
One possible explanation: A rise in the use of MRI scanning technology may be uncovering more strokes among younger patients than had been the case in the past.
"But for now we really can't say for sure why this is happening," Kissela cautioned. "But I would add that I think the findings are maybe not completely unexpected, given the rise of obesity, diabetes, high blood pressure and high cholesterol among younger and younger people. All of these are risk factors for stroke, and so that would naturally mean that the risk for stroke would get pushed forward."
"Young people should regularly go to their doctor and make sure their lab values are being checked," he added. "Because the consequences can be serious, even at a young age."
The new study was funded by the U.S. National Institutes of Health.
Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, pointed to insufficient physical activity as a possible culprit for the observed trends.
"There are three things that the American Heart Association has highlighted as being of greatest public health concern with regards to the decade that just ended," he noted. "Obesity, diabetes and physical inactivity."
"In the last decade, we saw reductions in stroke and heart mortality, and improved high blood pressure and cholesterol control overall," Sacco said. "But we did not see as much change in physical inactivity. Over the past decade it only dropped by 2.5 percent."
"So this problem may now be beginning to show up as an increased risk of stroke at younger ages," he suggested. "This study can't prove that. But it is certainly of great interest."

SOURCES: Brett Kissela, M.D., M.S., professor, vice chairman of neurology, University of Cincinnati College of Medicine, Ohio; Ralph Sacco, M.D., chairman, neurology, University of Miami Miller School of Medicine, Florida; Oct. 10, 2012, Neurology online

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