Stroke Rates Rising in Young and Middle-Aged Adults, Declining in Elderly


Last Updated: 2010-02-24 16:06:02 -0400 (Reuters Health)

By Karla Gale

NEW YORK (Reuters Health) - Stroke incidence has increased in young to middle-aged adults since 1993, while rates have actually declined in elderly people, according to results of a large population-based study.

"Because risk factors for stroke - diabetes, obesity, high blood pressure and cholesterol - are occurring at younger ages, we asked the question, is the age of stroke changing over time?" Dr. Brett M. Kissela, from the University of Cincinnati in Ohio, said in a phone call with Reuters Health.

He noted that diabetes increases the risk of stroke 3- to 4-fold, with the excess burden enhanced in people younger than 55.

Dr. Kissela presented his group's findings today at the American Stroke Association's International Stroke Conference in San Antonio, Texas.

In research funded by the U.S. National Institutes of Health, Dr. Kissela's group studies stroke in the Greater Cincinnati/Northern Kentucky region, population 1.3 million.

Between a 12-month period in 1993-1994 and the calendar year 2005, the average age of first stroke fell from 71.3 years to 68.4 years (p < 0.0001). At the same time, the proportion of strokes that occurred in people between ages of 20 and 45 years increased from 4.5% to 7.3%. (p < 0.0001).

Why the change?

"MRI scanners are widely available now, whereas they weren't in 1993, so we have a better ability to detect strokes, plus it's possible that doctors are looking more for strokes," Dr. Kissela said.

Of potentially greater consequence is the fact that "stroke is the end result of risk factors being present over time, and the longer you have hypertension, diabetes, high cholesterol, the more likely you are to have stroke," he continued. "If risk factors are occurring at an earlier age, then stroke may be as well."

Meanwhile, there has been a significant decrease in stroke incidence rates for blacks over age 85 and whites over age 65, which Dr. Kissela attributed to greater awareness of stroke risk factors on the part of both physicians and patients, and better treatments for controlling them.

Dr. Kissela and his associates did not detect a change in the overall incidence of stroke in children and adolescents.

"What Dr. Kissela described is concordant with what we're seeing right now in many different cities," Dr. Brian Silver, a neurologist at Henry Ford Hospital in Detroit and spokesman for the American Stroke Association, said in an audio statement. "It's clear that stroke is a lifelong risk, and that we can't think of it as a disease of the elderly anymore."

"I'm concerned that since 2005 to 2010 that there have been even further increases in the number of young people experiencing strokes," he added.

Copyright © 2010 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.