Stroke Incidence Increasing Among Children And Young Adults, USA

03 Sep 2011  

A large study has revealed that the rate of stroke among children, adolescents and young adults in the USA has been increasing at an alarming rate. The rate at which ischemic stroke patients are being hospitalized has also increased considerably, the authors reported in Annals of Neurology.

A stroke occurs when a ruptured blood vessel or blood clot interrupts blood flow to a part of the brain. If brain cells do not receive their supply of blood oxygen and glucose they die, leading to brain damage. The patient may subsequently have problems with memory, movement, speech, and could even die.

There are two main types of stroke:

• Ischemic stroke - accounts for about three-quarters of all strokes. A blood clot (thrombus) forms and blocks blood flow to an area of the brain. The blood clot could have formed somewhere else in the body, become dislodged and became free-floating in the bloodstream (embolus). It may travel in the bloodstream and make its way to the brain, where is causes an ischemic stroke.
• Hemorrhagic stroke - a blood vessel on the brain's surface ruptures and fills the space between the skull and the brain with blood (subarachnoid hemorrhage). Also, a faulty artery in the brain may burst, filling surrounding tissue with blood (cerebral hemorrhage). In both cases, there is a lack of blood flow to the brain and an accumulation of blood, raising pressure on the brain.

In this study, researchers found that over the period 1995-1996 to 2007-2008:

• Ischemic stroke incidence rose 50% among males aged 35 to 44 years
• Ischemic stroke incidence rose 46% among males aged 15 to 34.
• Ischemic stroke incidence rose 51% among boys aged 5 to 14.
• In 1996, 3.1 per 10,000 hospitalizations for boys were for ischemic stroke, compared to 4.7 in 2008.
• Among females aged 35 to 44, ischemic stroke incidence rose 29%
• Among females aged 15 to 34, ischemic stroke incidence rose 23%
• For girls aged 5 to 14, ischemic stroke incidence increase by just under 3%

Mary G. George, MD, MSPH, and team from the CDC said:

"The increase in the stroke hospitalization rate from 1995 to 2008 was 30% to 37% higher" among those aged 15-44. In the young adults and adolescents, we were surprised to see that large of an increase. Seeing this in a young population really underscores the need for adopting and maintaining healthy lifestyles from the time they are very young."

In this study, the investigators also looked at the traditional stroke risk factors.

Lee Schwamm, MD., vice chair of neurology at Massachusetts General Hospital and professor of neurology at Harvard Medical School said:

"The increasing incidence of risk factors in
young patients is very concerning."

Schwamm was not involved in the research but reviewed the findings.

The increase could be partly due it more advanced medical technology, George said. More accurate current imaging technology can probably identify a greater number of strokes among younger patients.

However, such risk factors as drug and alcohol abuse can be associated with strokes in a much briefer time frame.

George said:

"We found significant increases in high blood pressure, lipid [cholesterol] disorders, diabetes, tobacco use, and obesity . . . . things we consider traditional risk factors."

One in every three ischemic stroke patients aged 15-34 had three stroke factors, while half of 35-44 year olds with ischemic stroke had hypertension (high blood pressure). Approximately one in every for 35 to 44 year olds with ischemic stroke had diabetes.

The researchers also found that tobacco use, raised cholesterol and obesity were common problems among patients with ischemic stroke.

The following risk factors are said to be linked to stroke risk:

• A family history
• Having had a previous stroke
• Having had a TIA (transient ischemic attack)
• African Americans and those of Hispanic or Asian/Pacific Island descent have a higher risk of stroke
• Birth control pills
• Some other hormone therapies
• Cardiovascular disease
• Cocaine usage
• Diabetes
• Heavy alcohol consumption
• Hypertension
• High cholesterol
• High amino acid levels in the blood (hormocysteine)
• Obesity/overweight
• Smoking
• Being over 55 years of age

Written by Christian Nordqvist
Copyright: Medical News Today