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Stroke before 55 years of age at Karolinska Hospital 1973-77. A study of 399 well-defined cases. Risk indicators and
Insights
Cerebrovascular disease (CVD) in younger adults is linked to atherosclerosis, hypertension, diabetes, heart disease, and smoking. Oral contraceptive use is also a risk factor for stroke in young women.
Area of Science:
- Neurology
- Cardiovascular Research
- Epidemiology
Background:
- Cerebrovascular disease (CVD) presents unique etiological characteristics in patients under 55.
- Understanding these factors is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To investigate the etiological factors of cerebrovascular disease (CVD) in patients under 55 years old.
- To compare risk factors between ischemic and hemorrhagic stroke subtypes.
Main Methods:
- Retrospective review of 399 patients with CVD admitted between 1973-1977.
- Comparison with a control group of 829 age-matched individuals from the Stockholm population.
- Angiographic analysis to identify atherosclerosis and aneurysms.
Main Results:
- Atherosclerosis was evident in 61% of ischemic stroke patients.
- Significant associations (P < 0.05-0.001) were found between ischemic stroke and hypertension, diabetes, heart disease, and smoking.
- Oral contraceptive use was linked to stroke in women under 40 (P < 0.001).
- Aneurysms were found in 76% of subarachnoid hemorrhage patients, with 12% also showing atherosclerotic lesions.
- Hypertension, diabetes, and smoking were significantly associated (P < 0.01-0.001) with hemorrhagic stroke.
Conclusions:
- Atherosclerosis is a significant etiological factor in both ischemic and hemorrhagic cerebrovascular disease in younger adults.
- Hypertension, diabetes, smoking, and oral contraceptive use are key modifiable risk factors for CVD in this age group.
Abstract:
The etiological characteristics of cerebrovascular disease (CVD) before the age of 55 are reviewed in 399 patients admitted to the Department of Neurology, Karolinska Hospital, Stockholm, from 1973-77. The material was well-defined with regard to subtypes of stroke as well as to the diseased population. The control material consists of 829 males and females of corresponding age randomly selected from the Stockholm population. In the ischemic group, 61% had angiographic evidence of atherosclerosis and, compared to controls, in most patient groups a significant (P less than 0.05-0.001) association with hypertension, diabetes, heart disease and smoking was found as well as for female patients under age 40 the use of oral contraceptives (P less than 0.001). In the hemorrhagic group, angiography demonstrated aneurysms in 76% of the patients with subarachnoidal bleeding but also atherosclerotic lesions in about 12% of the whole group. This would imply that atherosclerosis is an important precursor also for hemorrhagic lesions, further supported by a significant (P less than 0.01-0.001) association of hypertension, diabetes and smoking with this group.