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Prevalence of cardiovascular risk factors and strokes in younger adults
  • Published Date:
    Jun 01 2017
  • Source:
    JAMA Neurol. 74(6):695-703
  • Language:
Filetype[PDF-142.60 KB]

  • Alternative Title:
    JAMA Neurol
  • Description:

    While stroke mortality rates have decreased substantially in the past two decades, this trend has been primarily limited to older adults. Increasing trends in stroke incidence and hospitalizations have been noted among younger adults, but there has been concern that this reflected improved diagnosis through an increased use of imaging rather than representing a real increase.


    We aimed to determine whether stroke hospitalization rates have continued to increase and to identify the prevalence of associated stroke risk factors among younger adults.

    Design, Setting, Participants

    Hospitalization data from the National Inpatient Sample from 1995 through 2012 were used to analyze acute stroke hospitalizations rates among young adults aged 18–64. Hospitalization data from 2003–2012 were used to identify the prevalence of associated risk factors for acute stroke. Acute stroke hospitalizations were identified by the principal ICD-9-CM code and associated risk factors were identified by secondary ICD-9-CM codes for each hospitalization.

    Main Outcomes

    Trends in acute stroke hospitalization rates by stroke type, age, sex, and race/ethnicity, as well as the prevalence of associated risk factors by stroke type, age, and sex.


    The major findings in this study are 1) ischemic stroke hospitalization rates increased significantly for both males and females and for certain race/ethnic groups among younger adults aged 18–54 and have almost doubled for males aged 18–34 and 35–44 years since 1995–96, with a 41.5% increase among males aged 35–44; 2) the prevalence of stroke risk factors among those hospitalized for acute ischemic stroke continued to increase from 2003–04 through 2011–12 for both males and females aged 18–64; and 3) the prevalence of having multiple risk factors among younger adults experiencing an acute ischemic stroke has nearly doubled over the decade. Hospitalization rates for intracerebral hemorrhage and subarachnoid hemorrhage remained stable.

    Conclusions and Relevance

    The identification of increasing hospitalization rates for acute ischemic stroke in young adults coexistent with increasing prevalence of traditional stroke risk factors confirms the importance of focusing on prevention in younger adults.

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