Stroke Increasing in the Young, CDC Reports

Pauline Anderson

September 12, 2011

September 12, 2011 — An increasing number of teenagers and young adults are being hospitalized for ischemic stroke, and more of them are diabetic, obese, have lipid disorders, and use tobacco or abuse alcohol, according to a new study.

"Urgent public health initiatives are needed to reverse the rising trends in modifiable risk factors and unhealthy behaviors associated with stroke in adolescents and young adults," write the authors, led by Mary G. George, MD, from the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention, Atlanta, Georgia.

The good news is that fewer young people are being hospitalized for subarachnoid hemorrhage, and the prevalence of sickle cell disease has decreased among children with ischemic stroke.

The study was published online September 1 in the Annals of Neurology.

Rising Stroke Rates

The aim of the study was to investigate the trends in acute stroke hospitalizations among children and young adults in a large national sample of hospitalizations. It also explored trends in risk factors for stroke in this population admitted with a diagnosis of acute stroke.

The study examined hospitalizations between 1995 and 2008 from the Nationwide Inpatient Sample, the largest nationwide all-payer hospital inpatient care database in the United States, for those aged 5 to 44 years. The analysis included 938 hospitals from 19 states in 1995, increasing to 1056 hospitals from 42 states and the District of Columbia in 2008.

The researchers found that just under half of the patients aged 5 to 14 years hospitalized for stroke experienced an ischemic stroke, about quarter experienced subarachnoid hemorrhage, and another quarter experienced intracerebral hemorrhage.

Results showed that although rates of ischemic stroke hospitalization have decreased among older adults during the past 15 years, the rates significantly increased among all adolescents and young adults (except girls aged 5 to 14 years) during the same time. The largest increases were for males in all age groups, at 51.6% in those aged 5 to 14 years, 45.6% in those aged 15 to 34 years, and 50.4% in those aged 35 to 44 years.

At the same time, hospitalizations for intracerebral hemorrhage also increased, by 36.8%, among the youngest population, and by 14.0% among men aged 15 to 34 years, although it dipped by 9.1% among women aged 15 to 34 years, and there was an overall decrease of 13.0% in all those aged 35 to 44 years.

As for hospitalizations for subarachnoid hemorrhage, these decreased among young people overall. There was a 50.0% increase among those aged 5 to 14 years, but a 14.3% decrease in those aged 15 to 34 years (even though males had an increase of 14.8%), and an overall decrease of 21.2% among those aged 35 to 44.

Many of the young people with stroke had risk factors. Almost a third of those aged 15 to 34 years, and one half of those aged 35 to 44, also had hypertension, and more than a quarter aged 35 to 44 had diabetes. About a third of men younger than 44 years and women aged 35 to 44 years used tobacco, as did a quarter of the women aged 15 to 34 years.

The rate of ischemic stroke hospitalization for children aged 5 to 14 years with sickle cell disease decreased by more than a half to 12.6% during the study period.

The authors have disclosed no relevant financial relationships.

Ann Neurol. Published online September 1, 2011. Abstract


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