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Stroke a growing risk for younger people

Updated: November 3, 2013 1:28PM



Stroke is primarily a concern for older adults, but about 5 percent of the 795,000 stroke victims in the United States each year are younger than 65.

And the latest research shows that younger people increasingly are at risk, with the incidence of stroke nearly doubling among adults under 55 from 1993 to 2005, according to a University of Cincinnati study.

“We found trends toward increasing stroke incidence at younger ages,” the Cincinnati researchers reported this month in the journal Neurology. “This is of great public health significance because strokes in younger patients carry the potential for greater lifetime burden of disability and because some potential contributors identified for this trend are modifiable.”

The researchers found a rising incidence of first strokes among people 20 to 54 years old — up from just under 13 percent in 1993 to over 18 percent in 2005.

In another study, the U.S. Centers for Disease Control and Prevention reported last year that the rate of hospitalization among those 15 to 44 years old for ischemic strokes — by far the most common type, occurring when an artery that supplies the brain becomes clogged — rose by 37 percent from 1995 to 2008.

Some of the rise could be the result of greater awareness of stroke among younger patients and better diagnostic technology, experts say, but researchers also have linked lifestyle risk factors such as obesity and the array of health problems it can cause, including high blood pressure and diabetes.

Some of the key risk factors for people under 65:

Obesity — Being overweight or obese can raise blood pressure and cholesterol levels and help lead to diabetes, which is a risk factor in itself. The conventional wisdom used to be that obesity was more a concern for strokes among older adults because it takes time for high blood pressure and cholesterol to lead to a stroke. But the increase among stroke victims under 45 shown in the CDC study and the risk factors seen in these younger patients suggests that obesity should be a red flag among people at a younger age, says Rush University Medical Center’s Dr. Shyam Prabhakaran.

Birth-control pills — Most of the 100 million women worldwide who use oral contraceptives can do so safely. But women who take even a low-estrogen birth-control pill can double their risk of stroke, though that risk is still relatively low. Birth-control pills have been associated with increased risk of blood clots and high blood pressure, which can lead to stroke. Women who are over 35, have high blood pressure or high cholesterol and are smokers or diabetic should be especially cautious about birth-control pills. Also, women who use birth-control pills with drospirenone — like Bayer’s Yaz and Yasmin — might have a higher risk of getting a blood clot, according to recent data reviewed by the U.S. Food and Drug Administration.

Carotid artery dissection — U.S. Sen. Mark Kirk (R-Ill.), 52, had a stroke in January caused by a carotid artery dissection, which happens when the inner lining of the artery tears, restricting the flow of blood to the brain. An estimated two or three people out of every 100,000 are affected over a lifetime. Carotid artery dissection can occur as a result of factors including blunt trauma to the neck; high blood pressure; and medical conditions such as Marfan syndrome and fibromuscular dysplasia. Sickle-cell disease — Sickle-cell affects one in 400 African Americans, and strokes occur in 6 to 12 percent of patients with sickle-cell disease, according to Dr. Jose Biller, chairman of the Department of Neurology at Loyola University Chicago Stritch School of Medicine. A stroke can happen if sickle cells cause blood flow to clog.

Drugs — Studies have shown that abuse of drugs such as amphetamines, cocaine and ecstasy can increase the risk of stroke.

“For people of any age, the healthy lifestyle factors such as physical activity, healthy diet with plenty of fresh fruit and vegetables, lower in sodium and knowing your family history...can help prevent risk factors that can lead to stroke,” says the CDC’s Mary G. George.

Younger people shouldn’t overlook potential signs of stroke such as sudden numbness in the face, an arm or leg; sudden trouble with one or both eyes; or sudden trouble walking. Seeking immediate medical help is key because the clot-dissolving drug tPA can be effective in treating stroke but has to be administered within three hours.



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