Rising Stroke rates among Young Adults and Children in the US

According to a large study published in the Annals of Neurology, there has been an alarming rise in stroke rates among children, adolescents, and young adults in the USA, in addition to increased hospitalizations of ischemic stroke patients.

Sometimes known as a “brain attack,” a stroke occurs when brain blood supply is interrupted by ruptured blood vessels or blood clots, following which brain cells cease to receive the required amounts of blood oxygen and glucose resulting in their death. This causes a brain damage, and consequently, patients may have problems with memory, movement, speech, or even fatality.

The two main types of stroke are:

Ischemic stroke – 75% of all strokes are of this type, wherein brain blood supply is blocked by a blood clot (thrombus). Having formed in some other body part, the clot could get dislocated and float freely in the bloodstream (embolus), after which it might make its way to the brain to cause an ischemic stroke.

Hemorrhagic stroke – This type of stroke is caused due to the rupture of a blood vessel on the brain’s surface causing the blood to occupy the gap between the skull and brain (subarachnoid hemorrhage). Additionally, the rupture of a damaged brain artery may fill the neighboring tissue with blood (cerebral hemorrhage). Both cases result in deficient blood supply to the brain and accumulation of blood, thereby increasing pressure on the brain.

Over a period ranging from 1995 to1996 and from 2007 to 2008, researchers found that:

Males between 35 and 44 years demonstrated a 50% rise in Ischemic stroke incidence
Males between 15 and 34 years demonstrated a 46% rise in Ischemic stroke incidence
Boys between 5 and 14 years demonstrated a 51% rise in Ischemic stroke incidence
For every 10,000 hospitalizations in 2008, 4.7 were for boys with ischemic stroke, compared to 3.1 in 1996.
Females between 35 to 44 years demonstrated 50% rise in ischemic stroke incidence
Females between 15 to 34 years demonstrated 23% rise in ischemic stroke incidence
Girls between 5 to 14 years demonstrated 3% rise in ischemic stroke incidence

CDC team as well as Mary G. George, MD, MSPH, said: “The increase in the stroke hospitalization rate from 1995 to 2008 was 30% to 37% higher” among those aged 15-44. In the young adults and adolescents, we were surprised to see that large of an increase. Seeing this in a young population really underscores the need for adopting and maintaining healthy lifestyles from the time they are very young.”

The study also examined traditional stroke risk factors.

Vice chair of neurology at Massachusetts General Hospital and professor of neurology at Harvard Medical School Lee Schwamm, MD., said:”The increasing incidence of risk factors in young patients is very concerning.”
Although Schwamm reviewed the findings, he was not a part of the research.

George said that the rise could be partly attributed to advanced medical technology and accurate current imaging technology that allows identification of larger stroke numbers among younger patients.

Stroke risk in a short span can be associated with risk factors such as drug and alcohol abuse.

George said: “We found significant increases in high blood pressure, lipid [cholesterol] disorders, diabetes, tobacco use, and obesity . . . . things we consider traditional risk factors.”

While 50% of ischemic stroke patients in the age group of 35 to 44 had hypertension (high blood pressure), one out of every three patients in the age group of 15 to 34 had three stroke factors. Furthermore, one out of every ischemic stroke patient in the age group of 35 to 44 had diabetes.

Study findings also demonstrated that the most common problems among ischemic stroke patients were tobacco use, raised cholesterol, and obesity.

Stroke is associated with the following risk factors, including a family history, previous stroke occurrence, occurrence of transient ischemic attack, African Americans and those of Hispanic or Asian/Pacific Island descent, birth control pills, hormone therapies, cardiovascular disease, cocaine usage, diabetes, heavy alcohol consumption, hypertension, high cholesterol, high amino acid levels in the blood (homocysteine), obesity/overweight, smoking, age (>55 years).

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