Tags

Type your tag names separated by a space and hit enter

Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults.
JAMA Neurol. 2017 06 01; 74(6):695-703.JN

Abstract

Importance

While stroke mortality rates have decreased substantially in the past 2 decades, this trend has been primarily limited to older adults. Increasing trends in stroke incidence and hospitalizations have been noted among younger adults, but there has been concern that this reflected improved diagnosis through an increased use of imaging rather than representing a real increase.

Objectives

To determine whether stroke hospitalization rates have continued to increase and to identify the prevalence of associated stroke risk factors among younger adults.

Design, Setting, and Participants

Hospitalization data from the National Inpatient Sample from 1995 through 2012 were used to analyze acute stroke hospitalization rates among adults aged 18 to 64 years. Hospitalization data from 2003 to 2012 were used to identify the prevalence of associated risk factors for acute stroke. Acute stroke hospitalizations were identified by the principal International Classification of Diseases, Ninth Revision, Clinical Modification code and associated risk factors were identified by secondary International Classification of Diseases, Ninth Revision, Clinical Modification codes for each hospitalization.

Main Outcomes and Measures

Trends in acute stroke hospitalization rates by stroke type, age, sex, and race/ethnicity, as well as the prevalence of associated risk factors by stroke type, age, and sex.

Results

The 2003-2004 set included 362 339 hospitalizations and the 2011-2012 set included 421 815 hospitalizations. The major findings in this study are as follows: first, acute ischemic stroke hospitalization rates increased significantly for both men and women and for certain race/ethnic groups among younger adults aged 18 to 54 years; they have almost doubled for men aged 18 to 34 and 35 to 44 years since 1995-1996, with a 41.5% increase among men aged 35 to 44 years from 2003-2004 to 2011-2012. Second, the prevalence of stroke risk factors among those hospitalized for acute ischemic stroke continued to increase from 2003-2004 through 2011-2012 for both men and women aged 18 to 64 years (range of absolute increase: hypertension, 4%-11%; lipid disorders, 12%-21%; diabetes, 4%-7%; tobacco use, 5%-16%; and obesity, 4%-9%). Third, the prevalence of having 3 to 5 risk factors increased from 2003-2004 through 2011-2012 (men: from 9% to 16% at 18-34 years, 19% to 35% at 35-44 years, 24% to 44% at 45-54 years, and 26% to 46% at 55-64 years; women: 6% to 13% at 18-34 years, 15% to 32% at 35-44 years, 25% to 44% at 45-54 years, and 27% to 48% at 55-65 years; P for trend < .001). Finally, hospitalization rates for intracerebral hemorrhage and subarachnoid hemorrhage remained stable, with the exception of declines among men and non-Hispanic black patients aged 45 to 54 with subarachnoid hemorrhage (13.2/10 000 to 10.3/10 000 hospitalizations and 15.8/10 000 to 11.5/10 000 hospitalizations, respectively).

Conclusions and Relevance

The identification of increasing hospitalization rates for acute ischemic stroke in young adults coexistent with increasing prevalence of traditional stroke risk factors confirms the importance of focusing on prevention in younger adults.

Authors+Show Affiliations

Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

28395017

Citation

George, Mary G., et al. "Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults." JAMA Neurology, vol. 74, no. 6, 2017, pp. 695-703.
George MG, Tong X, Bowman BA. Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. JAMA Neurol. 2017;74(6):695-703.
George, M. G., Tong, X., & Bowman, B. A. (2017). Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. JAMA Neurology, 74(6), 695-703. https://doi.org/10.1001/jamaneurol.2017.0020
George MG, Tong X, Bowman BA. Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. JAMA Neurol. 2017 06 1;74(6):695-703. PubMed PMID: 28395017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. AU - George,Mary G, AU - Tong,Xin, AU - Bowman,Barbara A, PY - 2017/4/11/pubmed PY - 2017/7/20/medline PY - 2017/4/11/entrez SP - 695 EP - 703 JF - JAMA neurology JO - JAMA Neurol VL - 74 IS - 6 N2 - Importance: While stroke mortality rates have decreased substantially in the past 2 decades, this trend has been primarily limited to older adults. Increasing trends in stroke incidence and hospitalizations have been noted among younger adults, but there has been concern that this reflected improved diagnosis through an increased use of imaging rather than representing a real increase. Objectives: To determine whether stroke hospitalization rates have continued to increase and to identify the prevalence of associated stroke risk factors among younger adults. Design, Setting, and Participants: Hospitalization data from the National Inpatient Sample from 1995 through 2012 were used to analyze acute stroke hospitalization rates among adults aged 18 to 64 years. Hospitalization data from 2003 to 2012 were used to identify the prevalence of associated risk factors for acute stroke. Acute stroke hospitalizations were identified by the principal International Classification of Diseases, Ninth Revision, Clinical Modification code and associated risk factors were identified by secondary International Classification of Diseases, Ninth Revision, Clinical Modification codes for each hospitalization. Main Outcomes and Measures: Trends in acute stroke hospitalization rates by stroke type, age, sex, and race/ethnicity, as well as the prevalence of associated risk factors by stroke type, age, and sex. Results: The 2003-2004 set included 362 339 hospitalizations and the 2011-2012 set included 421 815 hospitalizations. The major findings in this study are as follows: first, acute ischemic stroke hospitalization rates increased significantly for both men and women and for certain race/ethnic groups among younger adults aged 18 to 54 years; they have almost doubled for men aged 18 to 34 and 35 to 44 years since 1995-1996, with a 41.5% increase among men aged 35 to 44 years from 2003-2004 to 2011-2012. Second, the prevalence of stroke risk factors among those hospitalized for acute ischemic stroke continued to increase from 2003-2004 through 2011-2012 for both men and women aged 18 to 64 years (range of absolute increase: hypertension, 4%-11%; lipid disorders, 12%-21%; diabetes, 4%-7%; tobacco use, 5%-16%; and obesity, 4%-9%). Third, the prevalence of having 3 to 5 risk factors increased from 2003-2004 through 2011-2012 (men: from 9% to 16% at 18-34 years, 19% to 35% at 35-44 years, 24% to 44% at 45-54 years, and 26% to 46% at 55-64 years; women: 6% to 13% at 18-34 years, 15% to 32% at 35-44 years, 25% to 44% at 45-54 years, and 27% to 48% at 55-65 years; P for trend < .001). Finally, hospitalization rates for intracerebral hemorrhage and subarachnoid hemorrhage remained stable, with the exception of declines among men and non-Hispanic black patients aged 45 to 54 with subarachnoid hemorrhage (13.2/10 000 to 10.3/10 000 hospitalizations and 15.8/10 000 to 11.5/10 000 hospitalizations, respectively). Conclusions and Relevance: The identification of increasing hospitalization rates for acute ischemic stroke in young adults coexistent with increasing prevalence of traditional stroke risk factors confirms the importance of focusing on prevention in younger adults. SN - 2168-6157 UR - https://www.unboundmedicine.com/medline/citation/28395017/Prevalence_of_Cardiovascular_Risk_Factors_and_Strokes_in_Younger_Adults_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2017.0020 DB - PRIME DP - Unbound Medicine ER -