Temporal Trends in Vascular Risk Factor Burden Among Young Adults With Ischemic Stroke: The Florida Stroke Registry.

IF 8.5 1区医学 Q1 CLINICAL NEUROLOGY Neurology Pub Date : 2025-03-25 Epub Date: 2025-02-19 DOI:10.1212/WNL.0000000000213447

Aaron Shoskes, Lili Zhou, Hao Ying, Hannah Gardener, Ayham Alkhachroum, Ruijie Yin, Gillian L Gordon Perue, David Z Rose, Angus Jameson, Antonio Bustillo, Sebastian Koch, Erika T Marulanda, Carolina Marinovic Gutierrez, Tatjana Rundek, Jose G Romano, Negar Asdaghi

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Abstract

Background and objectives: Although ischemic stroke (IS) in young patients (aged 18-55) is believed to have different etiologies than in older patients, a rise in vascular risk factors (VRFs) among young adults may translate to an IS risk profile similar to the older population. We aimed to examine the prevalence of VRFs and temporal trends in VRF burden among young patients presenting with IS.

Methods: Data were prospectively collected by Get With the Guidelines-Stroke hospitals participating in the Florida Stroke Registry between January 2014 and December 2022. Patients aged 18-55 with a diagnosis of IS were included and separated into 2 age groups: 18-35 and 36-55. VRFs included hypertension, dyslipidemia, obesity, smoking, atrial fibrillation, coronary artery disease, heart failure, diabetes, and sleep apnea. Polymorbidity was defined as the presence of 3 or more VRFs.

Results: In total, 36,488 patients with IS were included (43% female, median age 49, 51% White), comprising 3,363 patients aged 18-35 (9.2%) and 33,125 aged 36-55 (90.8%). Non-Hispanic Black patients with IS had a significantly higher prevalence of polymorbidity than non-Hispanic White or Hispanic patients among both patients aged 18-35 (18.7% vs 11.0% vs 9.8%, p < 0.001) and those aged 36-55 (40.6% vs 37.6% vs 36.9% p < 0.001). In addition, male patients were found to have a higher prevalence of polymorbidity as compared with their female counterparts (37.9% vs 34.0%, p < 0.001). VRF burden worsened across the study period, with an increase in polymorbidity from 34.6% to 41.9% in patients 36-55 (p < 0.001) and from 10.9% to 16.4% in patients 18-35 (p = 0.002).

Discussion: Increasingly, young patients with stroke have traditional VRFs. The high prevalence of polymorbidity disproportionately affects non-Hispanic Black patients and male patients and has significantly increased over the past decade. Efforts targeting early identification and treatment of VRFs for primary prevention of stroke must target young populations to stem the rising tide of stroke in the young.

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年轻成人缺血性卒中血管危险因素负担的时间趋势：佛罗里达卒中登记。

背景和目的：尽管年轻患者（18-55岁）缺血性卒中（IS）的病因被认为与老年患者不同，但年轻人血管危险因素（vrf）的增加可能转化为与老年人群相似的IS风险特征。我们的目的是研究年轻IS患者中VRF的患病率和VRF负担的时间趋势。方法：2014年1月至2022年12月期间，参与佛罗里达州卒中登记的Get With the guidelines -卒中医院前瞻性收集数据。纳入18-55岁诊断为IS的患者，并将其分为18-35岁和36-55岁两个年龄组。vrf包括高血压、血脂异常、肥胖、吸烟、心房颤动、冠状动脉疾病、心力衰竭、糖尿病和睡眠呼吸暂停。多发病定义为存在3个或更多vrf。结果：共纳入36488例IS患者（43%为女性，中位年龄49岁，51%为白人），其中18-35岁3363例（9.2%），36-55岁33125例（90.8%）。非西班牙裔黑人IS患者在18-35岁（18.7%比11.0%比9.8%,p < 0.001）和36-55岁（40.6%比37.6%比36.9% p < 0.001）患者中多病患病率均显著高于非西班牙裔白人或西班牙裔患者。此外，男性患者的多病患病率高于女性患者（37.9% vs 34.0%, p < 0.001）。在整个研究期间，VRF负担加重，36-55岁患者的多病发生率从34.6%增加到41.9% (p < 0.001)， 18-35岁患者的多病发生率从10.9%增加到16.4% （p = 0.002）。讨论：越来越多的年轻中风患者使用传统的vrf。多病的高患病率不成比例地影响非西班牙裔黑人患者和男性患者，并且在过去十年中显着增加。针对vrf的早期识别和治疗以初级预防卒中的努力必须以年轻人群为目标，以遏制年轻人卒中的上升趋势。

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来源期刊

Neurology 医学-临床神经学

CiteScore

12.20

自引率

4.00%

发文量

1973

审稿时长

2-3 weeks

期刊介绍： Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology. As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content. Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.