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Stroke rates appear to be rising steadily in young adults

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The rate of stroke among young people has apparently been rising steadily since 1995, according to a study published this week. Hospitalization rates for stroke increased for women between the ages of 18 and 44, and nearly doubled for men in that age range from 1995 through 2012.

Using more-detailed data for 2003 through 2012, the researchers found that rates of hospitalizations for acute ischemic stroke increased by nearly 42 percent for men 35 to 44, while rates for women of the same age group increased by 30 percent over the same time, the study published in the JAMA, the Journal of the American Medical Association.

Across all adults, including those in older age ranges, stroke was the fifth leading cause of death in 2013. Overall mortality rates from strokes have significantly decreased over the past 50 years due to multiple factors, including better treatment for hypertension and increased use of aspirin, even as incidence of acute ischemic stroke among young adults has been on the rise.

The study also looked at stroke risk factors and whether there were any changes in their prevalence from 2003 to 2012. The likelihood of having three or more of five common risk factors — diabetes, hypertension, lipid disorders, obesity and tobacco use — doubled in men and women hospitalized for acute ischemic strokes.

“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,” said Mary George, the lead author of the report and deputy associate director for science and senior medical officer in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention.

Researchers used data from the National (Nationwide) Inpatient Sample, a large and nationally representative administrative database of hospital discharge information.

The researchers hypothesize that hospitalization rates kept increasing with time because stroke risk factors such as high blood pressure, diabetes and obesity have been increasing in the general population.

“The high and increasing rates of traditional stroke risk factors among young adults experiencing an acute stroke is quite worrisome,” George said.

The results reinforce the need for physicians to monitor patients for risk factors such as high blood pressure or high cholesterol and treat them early. Young adults and their health-care professional should have discuss engaging in healthy behaviors throughout their lives, such as eating a healthy diet with plenty of fruits and vegetables, being physically active, maintaining a healthy weight, and if they smoke then what steps they should take to quit, George said.

“Most people think that having a stroke is something that only happens to older people, but the impact of stroke is significant — it is uniquely complex in younger adults, in midst of careers, serving as wage earners and caregivers, who may suffer disability that can impact their lives and the lives of family members and loved ones,” George said.

Previous studies have looked at how stroke rates have increased in young adults, but this was a larger study that looked over a longer period of time, said Diana Greene-Chandos, a neurologist and director of neuroscience critical care at the Ohio State University Wexner Medical Center who was not part of the study.

“It showed us that not only was there an increase but also an increase that was associated with common risk factors in stroke,” she said. “It is  an important call to us as stroke neurologists and critical-care neurologists to start to study this more and more because of the way it was done. There are some limitations to it, but I think that it's enough good data that we should start to spend more of our resources in looking at this.”

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