Rising Stroke Incidence in Young Adults: More Epidemiological Evidence, More Questions to Be Answered

Béjot, Yannick; Delpont, Benoît; Giroud, Maurice

doi:10.1161/jaha.116.003661

Cited by 152 publications

(114 citation statements)

References 15 publications

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“…While the risk of stroke increases with age, it is increasingly recognised that stroke also occurs in younger populations. 1 Due to the wider impacts of disability on family, children, work and society, the burden of stroke in younger people is an increasing global problem. In addition, it is widely known that pregnancy is associated with an increased risk of stroke, and a recent report detailed maternal deaths from neurological disease including stroke and subarachnoid haemorrhage (SAH).…”

Section: Introductionmentioning

confidence: 99%

The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden

Ban

Sultan

Stephansson

et al. 2017

European Stroke Journal

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Introduction: Research has suggested that delivery is associated with an increased risk of stroke in women; however, there is a lack of contemporary estimates on the incidence of stroke in and after pregnancy compared with the baseline risk in women of childbearing age in Sweden. Patients and methods: All women aged 15-49 years with live births/stillbirths in 1992-2011 were identified from the Swedish Medical Birth Registry linked with the National Patient Registry. First stroke during the study period was identified. Incidence rates per 100,000 person-years and adjusted incidence rate ratios (IRRs) were calculated for antepartum, peripartum and early and late postpartum periods, compared with all other available follow-up time (time before pregnancy and after postpartum) using Poisson regression adjusted for maternal age, education attainment and calendar time. Results: Of 1,124,541 women, 3094 had a first incident stroke (331 occurred during pregnancy or first 12 weeks postpartum), about half having ischaemic stroke. The incidence was 15.0 per 100,000 person-years (95% confidence interval 14.5-15.6) in non-pregnant time. The incidence was lower antepartum (7.3/100,000 person-years, 6.0-8.9; adjusted IRR ¼ 0.7, 0.5-0.8) but higher peripartum (314.4/100,000 person-years, 247.5-399.5; adjusted IRR ¼ 27.3, 21.4-34.9) and early postpartum (64.0/100,000 person-years, 54.1-75.7; adjusted IRR ¼ 5.5, 4.6-6.6). The increased risk in peripartum was more evident for intracerebral haemorrhage than other types of stroke. Conclusion: Overall risk of stroke was low in women of childbearing age, but stroke risk peaks in the peripartum and early postpartum periods. Future work should address factors that contribute to this increased risk in order to develop approaches to attenuate risk.

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Section: Introductionmentioning

confidence: 99%

The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden

Ban

Sultan

Stephansson

et al. 2017

European Stroke Journal

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“…1,2 Although traditionally perceived as a disease of older age, stroke in younger individuals is increasingly emerging as a public health issue, 3,4 the average age at stroke onset is decreasing, and stroke incidence and hospitalization rates are rising among young in some countries. [5][6][7][8] A better understanding of contributions of modifiable risk factors to the burden of stroke in young adults is important for effective preventive strategies. Only recent studies have provided evidence that established stroke risk factors are more common in the young than previously assumed.…”

mentioning

confidence: 99%

Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Aigner

Grittner

Rolfs

et al. 2017

Stroke

196

154

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Background and Purpose-As stroke in young adults is assumed to have different etiologies and risk factors than in older populations, the aim of this study was to examine the contribution of established potentially modifiable cardiovascular risk factors to the burden of stroke in young adults. Methods-A German nationwide case-control study based on patients enrolled in the SIFAP1 study (Stroke In Young Fabry Patients) 2007 to 2010 and controls from the population-based GEDA study (German Health Update) 2009 to 2010 was performed. Cases were 2125 consecutive patients aged 18 to 55 years with acute first-ever stroke from 26 clinical stroke centers; controls (age-and sex-matched, n=8500, without previous stroke) were from a nationwide community sample. Adjusted population-attributable risks of 8 risk factors (hypertension, hyperlipidemia, diabetes mellitus, coronary heart disease, smoking, heavy episodic alcohol consumption, low physical activity, and obesity) and their combinations for all stroke, ischemic stroke, and primary intracerebral hemorrhage were calculated. Results-Low physical activity and hypertension were the most important risk factors, accounting for 59.7% (95% confidence interval, 56.3-63.2) and 27.1% (95% confidence interval, 23.6-30.6) of all strokes, respectively. All 8 risk factors combined explained 78.9% (95% confidence interval, 76.3-81.4) of all strokes. Population-attributable risks of all risk factors were similar for all ischemic stroke subtypes. Population-attributable risks of most risk factors were higher in older age groups and in men. Conclusions-Modifiable risk factors previously established in older populations also account for a large part of stroke in younger adults, with 4 risk factors explaining almost 80% of stroke risk. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.

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“…Ischemia-induced brain damage accounts for approximately 80% of the types of stroke 5 and may result in permanent disability, which severely impairs dependence and precipitates a large social expense. Furthermore, the incidence of stroke in young adults is experiencing an upward trend [23]. Therefore, the prevention and recovery of stroke are important issues.…”

Section: Discussionmentioning

confidence: 99%

Effects of pretreatment with methanol extract of Peucedani Radix on transient ischemic brain injury in mice

et al. 2017

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BackgroundStroke is the second most common cause of death and may result in various disabilities; thus, identification of neuroprotective therapeutic agents is important. Peucedani Radix (PR), the root of Angelica decursiva, is a well-known remedy for damp and phlegm in Korean medicine and has also been shown to exert antioxidant and anti-inflammatory activities. This study was performed to investigate the mechanism underlying the anti-inflammatory effect of methanol extract of PR (PRex) on cerebral ischemic injury.MethodsC57BL/6 male mice were orally administered PRex (20, 60, or 200 mg/kg) at 2 days, 1 day, and 1 h prior to middle cerebral artery occlusion (MCAO). Twenty-four hours after MCAO, the infarct volume was measured and the neurological deficit score was assessed. The inflammatory-related substances in the ipsilateral hemisphere were determined by western blotting, DCFH-DA assay, TBARS assay, and ELISA.ResultsPRex pretreatment significantly decreased the infarct volume at 24 h after MCAO. Moreover, PRex effectively suppressed the expression of iNOS, ROS, MDA, and pro-inflammatory cytokines, such as IL-1β and TNF-α, in brain tissue of mice with MCAO-induced brain injury.ConclusionsPRex protected neurons from ischemic brain injury in mice through its antioxidant and anti-inflammatory activities. Our results suggested that PR could be a promising candidate in the therapy of ischemia-induced brain damage.Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-017-0151-z) contains supplementary material, which is available to authorized users.

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Rising Stroke Incidence in Young Adults: More Epidemiological Evidence, More Questions to Be Answered

Abstract: International audienc

Cited by 152 publications

References 15 publications

The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden

The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden

Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Effects of pretreatment with methanol extract of Peucedani Radix on transient ischemic brain injury in mice

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