25 February 2010

Strokes up among the young

The incidence of stroke seems to be falling among the old. That's the good news.


The incidence of stroke seems to be falling among the old. That's the good news.

The bad news, though, is that strokes appear to be occurring more often among the young, a group that has not been considered at high risk for the debilitating and deadly condition, caused by a blood clot or bleeding in the brain.

Even as doctors are getting a handle on the problem among seniors, the proportion of strokes that occurred among those ages 20 to 45 rose from 4.5% in 1993-94 to 7.3% in 2005, according to new data. Researchers found that the average age of stroke patients also dropped by about three years, from 71.3 years old in 1993-94 to 68.4 in 2005.

Brett Kissela, associate professor and vice-chairman of education and clinical services at the University of Cincinnati Neuroscience Institute, called the findings "scary and very concerning."

A 'disturbing trend'

"Strokes are not that common among young people, but it's more common than it was in the past, which is a disturbing trend," said Kissela, lead author of the study, which is scheduled to be presented Wednesday at the American Stroke Association's International Stroke Conference in San Antonio.

Kissela said he launched the study after encountering a run of patients in their 50s who'd had strokes. He and his colleagues examined data from five counties in the Cincinnati and northern Kentucky region, which includes about 1.3 million people.

Diabetes and obesity

Among younger people, experts believe, the reason for the rise in strokes is probably a higher incidence of high blood pressure, diabetes and obesity.

"The epidemics of diabetes and obesity - and the high blood pressure that can come with that - are pretty significant risk factors for stroke," Kissela said. "These risk factors are more common among younger people than they were 15 or 20 years ago."

Wake-up call

The steep increase should be a wake-up call for doctors and their patients, Kissela said. "Young people and their doctors need to be aware that young people can be at risk of stroke," he said. "We need to look for these conditions early, and we need to treat them aggressively if we are going to prevent long-term complications for stroke."

Brian Silver, a spokesman for the American Stroke Association and a stroke neurologist at Henry Ford Hospital in Detroit, agreed that the study's finding rings true.

"It does match what we are seeing, which is an increase in young patients coming in with stroke," Silver said.

Obesity at the root of the problem

As he explained it, obesity can strain the heart, leading to hypertension, and it can also lead to insulin resistance and diabetes. Both diabetes and hypertension are primary risk factors for stroke. Over time, small strokes deep within the brain can lead to memory and thinking problems and, ultimately, dementia, Silver said.

To reduce the chances of having a stroke, Silver said, people need to keep their blood pressure and diabetes under control, watch their weight and exercise, Silver said.

Preventing disability

In the event of a stroke, research has shown that people do better if they're taken to what's known as a primary stroke centre, a specialty hospital that follows evidence-based protocols in caring for stroke victims, such as administering clot-busting drugs quickly.

Prompt medical attention is considered key to improving the odds of surviving and to preventing disabilities from a stroke. However, nearly half of US residents can't get to a primary stroke center within an hour, according to another study slated for presentation at the meeting.

Researchers from the University of California, San Diego, School of Medicine and the University of Pennsylvania noted that using more air ambulances could increase that to nearly 80%, however. - (Jennifer Thomas/HealthDay News)


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