HEALTH NEWS

Study Title:

Stroke Prevalence in Young Adults

Study Abstract

Objective:
The aim of this study was to determine acute stroke hospitalization rates for children and young adults and the prevalence of stroke risk factors among children and young adults hospitalized for acute stroke.

Methods:
The study population consisted of 1995–2008 hospitalizations from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke hospitalizations were identified by the primary International Classification of Diseases, 9th ed, Clinical Modification (ICD-9-CM) code. Seven consecutive 2-year time intervals were selected. Three age groups were utilized: 5 to 14 years, 15 to 34 years, and 35 to 44 years. Stroke risk factors and comorbidities among those hospitalized with acute stroke were identified by secondary ICD-9-CM codes.

Results:
During the period of study, the prevalence of hospitalizations of acute ischemic stroke increased among all age and gender groups except females aged 5 to 14 years. Females aged 15 to 34 years and males and females aged 35 to 44 years showed a decrease in the prevalence of hospitalizations for subarachnoid hemorrhage, whereas females aged 5 to 14 years showed increases for subarachnoid hemorrhage. Hypertension, diabetes, obesity, lipid disorders, and tobacco use were among the most common coexisting conditions, and their prevalence increased from 1995 to 2008 among adolescents and young adults (aged 15–44 years) hospitalized with acute ischemic stroke.

Interpretation:
Increases in the prevalence of ischemic stroke hospitalizations and coexisting traditional stroke risk factors and health risk behaviors were identified among acute ischemic stroke hospitalizations in young adults. Our results from national surveillance data accentuate the need for public health initiatives to reduce risk factors for stroke among adolescents and young adults.

From press release:

Ischemic stroke hospitalization rates in adolescents and young adults aged 15 to 44 increased up to 37% between 1995 and 2008 according to a study conducted by researchers at the Centers for Disease Control and Prevention (CDC). The findings available September 1 in Annals of Neurology, a journal of the American Neurological Association and the Child Neurology Society, report an increase in the prevalence of hypertension, diabetes, obesity, lipid disorders, and tobacco use among this age group during the 14-year study period.

The American Heart Association states that stroke is the third leading cause of death in the U.S. and 87% of all cases are attributed to ischemic stroke, in which blood flow to the brain is blocked by blood clots or build-up of fatty deposits called plaque (atherosclerosis) inside blood vessels. Prior studies report stroke in adolescents and young adults accounts for 5% to 10% of all stroke incidences, and is one of the top 10 causes of childhood death.

CDC researchers used hospital discharge data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project to identify patients hospitalized for ischemic stroke. Stroke risk factors and comorbidities among those hospitalized with stroke were also analyzed. "We identified significant increasing trends in ischemic stroke hospitalizations among adolescents and young adults," said Mary George, M.D., M.S.P.H., lead author of the study and a medical officer with CDC's Division for Heart Disease and Stroke Prevention. "Our results from national surveillance data accentuate the need for public health initiatives to reduce the prevalence of risk factors for stroke among adolescents and young adults."

Of the patients hospitalized for ischemic stroke, the study found that nearly one in three patients aged 15 to 34 years and over half aged 35 to 44 years were also diagnosed with hypertension. One-fourth of patients aged 35 to 44 years also had diabetes. One in four females aged 15 to 34, one in three females aged 35 to 44, and one in three males aged 15 to 44 were tobacco users. Other common co-existing conditions included obesity and lipid disorders.

The authors advised that adolescents, their guardians, and young adults can help avoid stroke by preventing and controlling hypertension, diabetes, and cholesterol; eating plenty of fresh fruits and vegetables and foods low in sodium and saturated fat; maintaining a healthy weight; engaging in regular physical activity; and not smoking.

CDC is working with public- and private-sector partners at the national, state, and local levels to educate Americans about the risk factors, health effects, and prevention measures of stroke. The agency is also enhancing the monitoring of stroke causes, associated conditions, and hospitalizations, as well as expanding the scientific literature on these topics.

Study Information

Mary G. George, Xin Tong, Elena V. Kuklina, Darwin R. Labarthe.
Trends in Stroke Hospitalizations and Risk Factors in Children and Young Adults: 1995-2008.
Annals of Neurology.
2011 September
Centers for Disease Control and Prevention (CDC).