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Age-Specific Vascular Risk Factor Profiles According to Stroke Subtype
Allard J Hauer1, Ynte M Ruigrok1, Ale Algra1,2,3
1Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Vascular risk factors vary significantly across different stroke subtypes and age groups. Understanding these age-specific patterns is crucial for developing targeted stroke prevention strategies for diverse patient populations.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Epidemiology
Background:
- Stroke is a heterogeneous disease with diverse subtypes and causes.
- Limited data exists on how vascular risk factors are distributed across stroke subtypes by age.
- This study investigates age-related prevalence of vascular risk factors in different stroke types.
Purpose of the Study:
- To examine the prevalence of vascular risk factors in various stroke subtypes.
- To analyze how these prevalences differ across age groups.
- To inform tailored stroke prevention strategies.
Main Methods:
- Prospective, multicenter study of 4033 patients.
- Analysis of ischemic stroke (large artery atherosclerosis, small vessel disease, cardioembolism) and hemorrhagic stroke (intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage) subtypes.
- Stratification of vascular risk factors by four age groups: <55, 55-65, 65-75, and ≥75 years.
Main Results:
- Younger patients (<55 years) with certain stroke subtypes were more often non-white and smokers.
- Hypertension, hyperlipidemia, and diabetes increased with age across all stroke types.
- Smoking prevalence decreased with age.
- Accumulation of modifiable risk factors was highest in large artery atherosclerosis and small vessel disease stroke, irrespective of age.
Conclusions:
- Age-specific patterns of cardiovascular risk factors exist across different stroke subtypes.
- Recognizing these distinct patterns is essential for effective, individualized stroke prevention.
- Tailored prevention efforts can target specific risk groups based on age and stroke type.
Background:
Ischemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age.
Methods And Results:
We studied a prospective multicenter university hospital-based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage, we calculated prevalences of vascular risk factors in 4 age groups: <55, 55 to 65, 65 to 75, and ≥75 years, and mean differences with 95% CIs in relation to the reference age group. Patients aged <55 years were significantly more often of non-white origin (in particular in spontaneous intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage patients) and most often smoked (most prominent for aneurysmal subarachnoid hemorrhage patients). Patients aged <55 years with ischemic stroke caused by large artery atherosclerosis or small vessel disease more often had hypertension, hyperlipidemia, and diabetes mellitus than patients with ischemic stroke of cardiac origin. Overall, the frequency of hypertension, hyperlipidemia, and diabetes mellitus increased with age among all stroke subtypes, whereas smoking decreased with age. Regardless of age, accumulation of potentially modifiable risk factors was most pronounced in patients with ischemic stroke caused by large artery atherosclerosis or small vessel disease.
Conclusions:
The prevalence of common cardiovascular risk factors shows different age-specific patterns among various stroke subtypes. Recognition of these patterns may guide tailored stroke prevention efforts aimed at specific risk groups.
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