Strokes Striking Younger People

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Diabetes, Obesity, High Blood Pressure Among Triggers, Expert Says
By Kathleen Doheny
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 10, 2012 -- People are having strokes at younger ages, according to new research.
"This is still a disease of the old, but a surprisingly higher proportion of younger patients are having strokes, and it's getting worse over time," says researcher Brett Kissela, MD, professor and vice chair of neurology at the University of Cincinnati.
Meanwhile, strokes are decreasing among older people, he found.
In his study, strokes among adults under age 55 grew from about 13% in 1993 to 19% in 2005.
The study, funded by the National Institutes of Health, is published in Neurology.
"Our data cannot tell us why exactly this is happening," he says. "Perhaps the largest factor has to do with the early appearance of risk factors."
He's referring to the rates of diabetes, high blood pressure, and obesity among younger people, all risk factors for strokes.
Better diagnostic methods may also be playing a role, he says.
About 795,000 Americans are affected by stroke annually, according to the American Stroke Association.*
Most are ischemic strokes, caused by an obstruction within the blood vessel. Others occur when a blood vessel ruptures, called hemorrhagic strokes.
[h=3]Strokes in Younger People: The Numbers[/h] For the study, Kissela's team looked at strokes in Cincinnati and Northern Kentucky. The regions included two Ohio counties and three Kentucky counties served by 17 hospitals in 2005.
They only studied first strokes.

• The average age of first strokes fell from 71 years in 1993-94 to 69 years in 2005.
• The rates of strokes in people aged 20 to 54 was higher in 2005 compared to the earlier time points.
• At each of the time points, there were about 2,000 strokes.
• Looking at just people aged 20-44, the number of strokes bumped up from 88 in 1993-94 to 140 in 2005.
• The percent of all strokes affecting people 55 and older dropped over time.

Although Kissela's study looked only at one region of the country, a CDC study released in 2011 found the same trends nationwide.
[h=3]Strokes in Younger People: Beyond Statistics[/h] The impact of a younger person having a stroke is great, Kissela says.
If a stroke is severe, the patient could be sent to an assisted living facility, with long-term disruption and economic effects on the family. There are also long-term costs to society, he says.
Kissela began to study stroke rates in younger people after he noticed more of them coming to the hospital for treatment.
Besides an increase in risk factors, better imaging techniques could be part of the reason more strokes are being diagnosed at younger ages, he says.
[h=3]Stroke in Younger People: Perspective[/h] Other factors besides individual risk factors may explain the rise, says Mitchell S.V. Elkind, MD, associate professor of neurology and epidemiology at Columbia University. He co-wrote an editorial to accompany the study.
"I really do think there has been a lot of change in how we diagnose strokes, primarily imaging advances," he says.
Even so, he says, "I think the main message is that although strokes are much more common in older people, they do affect younger people."
Another message, he says, is to pay attention to possible stroke symptoms.
The American Stroke Association recommends the acronym FAST to learn the warning signs and what to do:

• Face drooping
• Arm weakness
• Speech difficulty
• Time to call 9-1-1.

Get to the hospital as soon as possible, Elkind says. "The best treatments work very quickly after stroke occurs," he says.
Improving health habits can also lower stroke risk, he says. That means exercising regularly, not smoking, and eating a diet with plenty of fruits and vegetables and low salt.
Elkind reports consultant work for Jarvik Heart, research support from diaDexus, Inc. and Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership. He has provided expert testimony on behalf of Novartis, GlaxoSmithKline, and Organon. He is compensated as an editor for the journal Neurology.