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Risk Factors for Early-Onset Ischemic Stroke: A Case-Control Study.

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  • 11 Clinical Neurosciences University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland.

Journal of the American Heart Association
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Vascular risk factors like atrial fibrillation, cardiovascular disease, and diabetes significantly increase the risk of early-onset ischemic stroke (IS) in adults aged 25-49. Smoking and hypertension also contribute to IS risk.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Increasing prevalence of vascular risk factors in young adults with ischemic stroke (IS).
  • Need to establish the strength of association between all vascular risk factors and early-onset IS.

Purpose of the Study:

  • To compare vascular risk factors in patients with first-ever IS (25-49 years) versus stroke-free controls.
  • To identify significant associations between specific vascular risk factors and early-onset IS.

Main Methods:

  • Population-based cohort study (FINRISK) including 961 IS patients and 1403 controls.
  • Assessed 11 vascular risk factors: malignancy, atrial fibrillation, cardiovascular disease, smoking, family history of stroke, dyslipidemias, hypertension, and diabetes mellitus.
  • Multivariable logistic regression and subgroup analyses by age, sex, and IS etiology.

Main Results:

  • Atrial fibrillation (OR 10.43), cardiovascular disease (OR 8.01), type 1 diabetes (OR 6.72), and type 2 diabetes (OR 2.31) showed strong associations with IS.
  • Other significant risk factors included low HDL cholesterol, current smoking, hypertension, and family history of stroke.
  • High LDL cholesterol showed an inverse association; current smoking and type 1 diabetes were most consistent across subgroups.

Conclusions:

  • This study confirms associations between 11 vascular risk factors and early-onset IS.
  • Atrial fibrillation, cardiovascular disease, type 1, and type 2 diabetes mellitus are particularly strong predictors of IS in younger adults.
  • Findings highlight the importance of managing vascular risk factors to prevent IS in the young adult population.