Analysis of Risk Factors Associated with Stroke in Young Adults: A Prospective Study

Abstract

Objective: Stroke in young patients is not common. The purpose of this study was to find out the risk factors of stroke in young adults in Bangladesh and to compare with different other studies. Methods: 85 young adult cases of stroke patients with the age ranging from 14 to 45 years, admitted in different medical units of Dhaka Medical College Hospital from January 2008 to July 2009, were studied. The risk factors for stroke and the distribution of stroke types were analyzed. Results: The specific age group (14-45 years old) included 6% of patients of all ages admitted for stroke. Among 85 patients, cerebral infarction was diagnosed in 52 patients (61%). Intracerebral hemorrhage (without trauma) was diagnosed in 25 patients (29.4%). Subarachnoid hemorrhage was found in 7 young patients (8.24%). The most common risk factors for ischemic stroke were hypertension (57.68%), hypercholesterolemia (38.46%), diabetes (34.61%), smoking (32.69%), premature atherosclerosis (11.54%). Regarding aetiology of cerebral infarction, the majority due to cardiogenic emboli (75%). The use of oral contraceptives, pregnancy, SLE, migraine and moya moya disease were infrequent causes of cerebral infarction. In ischemic stroke, the ratio of cardiogenic emboli & other factors were 3:1. The most common risk factors for hemorrhagic stroke were hypertension (63.63%), hypercholesterolemia (39.39%), diabetes (36.54%) & smoking (33.33%). Conclusion: Hypertension, Diabetes, tobacco smoking, premature atherosclerosis & rheumatic valvular heart disease are growing problems in the developing countries. According to our finding, identification & treatment of hypertension, dyslipidaemia, diabetes & rheumatic valvular heart disease & cessation of smoking are proper measures to prevent morbidity & mortality. Key words: Risk factors; stroke; young adult. DOI: 10.3329/jdmc.v18i2.6265 J Dhaka Med Coll. 2009; 18(2) : 95-99

Nasogastric Tube Feeding Practice and Associated Complication in stroke Patients in a Tertiary Care Hospital in Bangladesh

“…In this study hypertension was the most important risk factor of stroke, followed by smoking and diabetes mellitus, dyslipidaemia. Two previous Bangladeshi studies conducted by Siddique et al and Hossain also describes similar findings 14,16 . In a study done by Miah et al, reported that 78% of the stroke patients' required NG tube feeding for stroke 17 .…”

Young Ischemic Stroke in South Asia: A review

“…34 Hossain et al and Lipska et al also reported significant number of hyperlipidemic young strokes, 38% and 29% respectively. 15,17 Study in Iran, Pakistan and Srilanka showed a relative less prevalence of hyperlipidemia among young stroke. 9,14,35,36 A comparative study of ethnic South Asians and Whites in United Kingdom reported that the percentage of hyperlipidemic people was significantly higher among young South Asians.…”

“…55 Figure 1 shows higher frequency of cardioembolism was present among young ischemic stroke patients of Hossain and Ghandehari. 15,19 Valvular heart diseases, including congenital and acquired, were the major findings in their studies. Other common sources of cardioembolism in young stroke were infective endocarditis, cardiomyopathy, myxoma, acute myocardial infarction, akinetic ventricular segment, etc ( Table 2).…”

“…9,14,15 Some studies showed that hypertension was more associated with intracerebral hemorrhage than cerebral infarction. 25,26 High blood pressure is also related with increased risk of stroke death.…”

Medical Conditions Related to Ischemic And Haemorrhagic Stroke: A Hospital Based Study

“…The prevalence of stroke here is 3 per 1000 above the age of 40 years 15 . We could find few similar studies involving stroke patients [16][17][18] .…”