Lifestyle-Associated Risk Factors for Acute Brain Infarction Among Persons of Working Age

Haapaniemi, Helena; Hillbom, Matti; Juvela, Seppo

doi:10.1161/01.str.28.1.26

Cited by 93 publications

(98 citation statements)

References 32 publications

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“…Our findings regarding the gender disparity of these vascular risk factors are in line with other studies. 6,22,23 The importance of classical vascular risk factors for strokes in the young is further substantiated by our finding of a high prevalence of silent infarcts and WMHs on MRI: silent infarcts were present in 20% of patients with a firstever ischemic stroke and in 11% of patients with first-ever TIA (and no previous stroke), and WMHs of any degree were present in almost half of all patients. Whereas silent infarcts and WMHs are quite common in the elderly general population, they are distinctly uncommon in persons <55 years: in the Framingham Offspring Study <8% of persons aged 30 to 49 years had a silent brain infarct, and other studies have reported even lower rates.…”

Section: Discussionmentioning

confidence: 68%

Acute Cerebrovascular Disease in the Young

Heuschmann¹,

Jungehülsing²,

Giese³

et al. 2013

Stroke

194

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Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396) *Drs Rolfs, Fazekas and Grittner contributed equally to this work. Authors contributions: Dr Rolfs has conceptualized, initiated, and designed and organized the study, has been involved in the recruitment of the patients, and wrote significant parts of the manuscript. Dr Fazekas was involved in the study planning and has done together with Drs Enzinger and Schmidt the analysis of all MRI scans; this group was mainly involved in the statistical analysis of the MRI data. Drs Martus, Grittner, Holzhausen have taken responsibility for all statistical analysis and for the data structure of the total data bank. Drs Dichgans, Böttcher, Tatlisumak, Tanislav, Jungehulsing, Putaala, Huber, Bodechtel, Lichy, Hennerici, Kaps, Meyer, Kessler have been most active in the recruitment of the patients, drafting the manuscript and significantly influencing the scientific discussion. Dr Heuschmann was involved in drafting the manuscript and influencing the scientific discussion. Dr Norrving chaired the steering and publication committees of sifap, has written parts of the manuscript, and has significantly influenced the scientific discussions. Drs Lackner and Paschke, H. Mascher, Dr Riess have been involved in the laboratory analyses. Dr Kolodny has mostly contributed to the discussion of the Fabry cases. Dr Giese assisted in writing and editing the manuscript. All authors have reviewed, critically revised and approved the final version of the manuscript.The sponsors of the study had no role in the study design, data collection, data analysis, interpretation, writing of the manuscript, or the decision to submit the manuscript for publication. The academic authors had unrestricted access to the derived dataset, and assume full responsibility for the completeness, integrity, and interpretation of the data, as well as writing the study report and the decision to submit for publication.†Listed in Appendix I in the online-only Data Supplement. Jeffrey L. Saver, MD, was guest editor for this article.

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Section: Discussionmentioning

confidence: 68%

Acute Cerebrovascular Disease in the Young

Heuschmann¹,

Jungehülsing²,

Giese³

et al. 2013

Stroke

194

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“…88 Thirty percent of women with cerebral infarction in a study by Hilton-Jones and Warlow 97 were found to be OC users; 15% of the patients had a history of migraine. In a study of women with first stroke, Haapaniemi et al 98 found OC use to be an independent risk factor for ischaemic brain infarction. Among 15 to 44-yearold OC users who had had a cerebral thromboembolic attack studied by Lidegaard 99 during a 5-year period in Denmark, the risk of stroke was six times greater among diabetic women who had had previous thrombotic disease, and three times greater among women with hypertension or migraine.…”

Section: Journal Of Human Hypertensionmentioning

confidence: 99%

Hypertension in women

Rosenthal

Oparil

2000

J Hum Hypertens

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Hypertension in women has received less attention than hypertension in men, and the major controlled trials of antihypertensive therapy have been carried out in populations made up predominantly of and have emphasised outcomes in men. Recently it has been recognised that women develop high blood pressure, particularly systolic hypertension, at an increased rate as they age, and that this age-related blood pressure increase is exaggerated by the menopause. The age-related rise in blood pressure, particularly systolic blood pressure and pulse pressure, contributes substantially to the age-related increase in risk of heart attack, heart failure, and stroke in middle-aged and elderly women. This article reviews

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“…Young patients differ from other patients with stroke with regards to risk factors, causes, and outcome of stroke. [20][21][22][23][24][25] Therefore, the objectives of our study were to characterize PI and PSI in young patients with first-ever stroke and to explore whether they are associated with worse 3-month outcome and longterm mortality or recurrent vascular events.…”

mentioning

confidence: 99%

Preceding and Poststroke Infections in Young Adults With First-Ever Ischemic Stroke

Heikinheimo

Broman

Haapaniemi

et al. 2013

Stroke

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This retrospective study is based on the Helsinki Young Stroke Registry data. The registry includes all consecutive 15-to 49-year-old Background and Purpose-Poststroke infections (PSIs) worsen the outcome in acute ischemic stroke, but the effect of preceding infection (PI) is controversial. Data on young patients are scarce. We characterized PI and PSI in young adults with first-ever stroke and studied whether they are associated with 3-month and long-term outcomes, recurrent vascular events, and death. Methods-From our database of 1008 consecutive patients aged 15 to 49 years, we included in the present study those who had brain imaging done within the first 2 days from stroke onset. Outcomes were unfavorable at 3 months and during long-term follow-up, vascular events, and all-cause death. Logistic regression and Cox proportional models were used to determine associations between infections and clinical outcomes. Results-A total of 681 patients (62.3% men) fulfilled the inclusion criteria. Of these, 70 (10.3%) had PI, most commonly upper respiratory tract infection, and 103 (15.1%) had PSI, most commonly pneumonia. After adjusting for sex, age, and risk factors, both PI (odds ratio, 2.86; 95% confidence interval, 1.48-5.54) and PSI (odds ratio, 2.26; 95% confidence interval, 1.08-4.76) were independently associated with unfavorable 3-month outcome. PSI was also associated with long-term (follow-up, 7.8±4.0 years) higher risk of all-cause death. Conclusions-In young patients with ischemic stroke, both PI and PSIs are associated with unfavorable short-term outcome.PSIs are also associated with higher long-term mortality. (Stroke. 2013;44:3331-3337.)

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Lifestyle-Associated Risk Factors for Acute Brain Infarction Among Persons of Working Age

Cited by 93 publications

References 32 publications

Acute Cerebrovascular Disease in the Young

Acute Cerebrovascular Disease in the Young

Hypertension in women

Preceding and Poststroke Infections in Young Adults With First-Ever Ischemic Stroke

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