Different risk factor profiles in young and elderly stroke patients with special reference to cardiac disorders
K Zeiler1, P Siostrzonek, W Lang
1Neurological University Clinic, I. Medical University Clinic, Vienna, Austria.
Insights
Risk factors for ischemic stroke differ significantly by age. Younger patients present with migraine and mitral valve prolapse, while older patients show hypertension and diabetes. Cardiac screening is crucial for all stroke patients.
Area of Science:
- Neurology
- Cardiology
- Epidemiology
Background:
- Ischemic cerebrovascular disorders affect patients of all ages.
- Understanding age-specific risk factors is crucial for effective prevention and treatment.
- Previous studies have shown varying risk factor profiles but often lack age stratification.
Purpose of the Study:
- To compare the risk factor profiles of ischemic stroke in young (< or = 40 years) versus older (> 40 years) patients.
- To identify age-dependent differences in cerebrovascular disease etiology.
- To assess the prevalence of cardiac risk factors in different age groups.
Main Methods:
- Retrospective case-control study comparing 77 young patients with 138 older patients.
- Analysis of demographic data, medical history, and cardiovascular risk factors.
- Evaluation of cardiac disorders including atrial fibrillation, left ventricular hypertrophy, coronary heart disease, and mitral valve disease.
Main Results:
- Younger patients had higher rates of migrainous headache and mitral valve prolapse.
- Older patients exhibited more frequent hypertension, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia.
- Oral contraceptive use was significantly higher in young women (65%) compared to the general population (28%).
- Cardiac disorders were more prevalent in older patients.
- High cardiac risk for stroke was identified in 9.1% of younger patients and 42.8% of older patients.
Conclusions:
- Risk factor profiles for ischemic stroke are distinctly different between young and older populations.
- Migraine and mitral valve prolapse are notable in younger patients, while traditional cardiovascular risks dominate in older patients.
- Electrocardiographic and echocardiographic screenings are vital for identifying cardiac risks, especially in younger individuals.
- Age-related distribution of risk factors explains discrepancies in previous research on ischemic stroke etiology.
Abstract:
The risk factors of ischemic cerebrovascular disorders in 77 young patients (< or = 40 years) were compared to those in 138 older patients (> 40 years). The risk factor profile of patients with juvenile stroke was considerably different from that of older patients. Migrainous headache and mitral valve prolapse occurred more frequently in the younger age group, whereas hypertension, diabetes mellitus, high levels of cholesterol and triglycerides were found more often in older patients with stroke. 65% of the women under the age of 40 took oral contraceptives which compares to the baseline community value of 28% of women in childbearing age in this country. Cardiac disorders such as atrial fibrillation, left ventricular hypertrophy, coronary heart disease including a history of myocardial infarction, as well as mitral valve disease were demonstrated more often in the group of elderly patients. 7 out of 77 younger patients (9.1%), and 59 out of 138 older patients (42.8%) were considered to belong to a group with "high cardiac risk for stroke". The results of this study indicate that electrocardiographic screening is of prime importance for detecting cardiac risk factors. However, echocardiographic examination often yields additional diagnostic information, particularly in younger patients. The conflicting opinions concerning the relevance of certain risk factors for ischemic stroke could partly be explained by the fact that these risk factors are distributed unevenly depending on age.
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