Age‐Specific Vascular Risk Factor Profiles According to Stroke Subtype

Abstract

BackgroundIschemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age.Methods and ResultsWe studied a prospective multicenter university hospital–based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage, we calculated prevalences of vascular risk factors in 4 age groups: <55, 55 to 65, 65 to 75, and ≥75 years, and mean differences with 95% CIs in relation to the reference age group. Patients aged <55 years were significantly more often of non‐white origin (in particular in spontaneous intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage patients) and most often smoked (most prominent for aneurysmal subarachnoid hemorrhage patients). Patients aged <55 years with ischemic stroke caused by large artery atherosclerosis or small vessel disease more often had hypertension, hyperlipidemia, and diabetes mellitus than patients with ischemic stroke of cardiac origin. Overall, the frequency of hypertension, hyperlipidemia, and diabetes mellitus increased with age among all stroke subtypes, whereas smoking decreased with age. Regardless of age, accumulation of potentially modifiable risk factors was most pronounced in patients with ischemic stroke caused by large artery atherosclerosis or small vessel disease.ConclusionsThe prevalence of common cardiovascular risk factors shows different age‐specific patterns among various stroke subtypes. Recognition of these patterns may guide tailored stroke prevention efforts aimed at specific risk groups.

Prevalence and risk factors of ischaemic stroke in the young: a regional Australian perspective

“…The implication of this is that the high prevalence of traditional vascular risk factors is not solely responsible for the stroke in the youngest group. However, the even higher prevalence of vascular risk factors in the oldest group who also have high frequencies of associated stroke mechanisms, suggest that they become more relevant with greater number of years exposed to the risk factors . Whilst the frequency of cryptogenic strokes in the youngest group in our population (46.7%) was higher than that reported in the literature, which ranges from 22 to 40%, true cryptogenic strokes only accounted for 13.3% of the ischaemic strokes, in that group, in our the study.…”

Ischaemic stroke in young adults: a global perspective

“…3 4 35 54 Young stroke patients have approximately twice as many risk factors compared with their peers 54. Furthermore, the prevalence of having multiple risk factors is increasing 36 54 55. The risk of future vascular events increases equally with the number of risk factors 56.…”

“…The prevalence of lipid disorders in young adults increases 54. Dyslipidaemia is more often found in patients with large artery disease or small vessel disease, and is less common in ischaemic stroke caused by cardiac embolism 55. Dyslipidaemia in young adults is not significantly associated with the risk of all-cause stroke (PAR of −2.1%; 95% CI −6.7 to 2.6 and OR=0.9; 95% CI 0.8 to 1.1) 53.…”

Dutch Parelsnoer Institute-Cerebrovascular Accident (CVA) Study: A Large Multicenter Clinical Biobank with Standardized Collection and Storage

“…PSI is a cooperation of all eight Dutch University Medical Centers (UMCs) and aims at building large prospectively collected datasets with uniform and standardized storage of biomaterials for complex diseases. Currently, PSI covers 18 disease-specific cohorts called 'Pearls', and this number is still growing [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. PSI is centrally organized and has an executive board for operational management to ensure collective standardization strategies.…”

“…Regarding all disease cohorts, the research projects based on PSI data and samples have led to several scientific publications [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]18].…”