The Growing Problem of Stroke among Young Adults

Sultan, Sally; Elkind, Mitchell S.V.

doi:10.1007/s11886-013-0421-z

Cited by 46 publications

(41 citation statements)

References 65 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the overall incidence of strokes has been declining in developed countries during the past 2 decades, the absolute number of people who have a stroke every year and live with its consequences is increasing. 1,2 Moreover, there is troubling evidence of an increasing incidence of strokes among young adults. 3 Studies have shown that >90% of the stroke burden is attributable to modifiable risk factors, such as tobacco smoking, alcohol consumption, poor diet, low physical activity, and hypertension.…”

mentioning

confidence: 99%

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Falkstedt

Wolff

Allebeck

et al. 2017

Stroke

View full text Add to dashboard Cite

Background and Purpose-Current knowledge on cannabis use in relation to stroke is based almost exclusively on clinical reports. By using a population-based cohort, we aimed to find out whether there was an association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol. Methods-The cohort comprises 49 321 Swedish men, born between 1949 and 1951, who were conscripted into compulsory military service between the ages of 18 and 20. All men answered 2 detailed questionnaires at conscription and were subject to examinations of physical aptitude, psychological functioning, and medical status. Information on stroke events up to ≈60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age. Results-No associations between cannabis use in young adulthood and strokes experienced ≤45 years of age or beyond were found in multivariable models: cannabis use >50 times, hazard ratios=0.93 (95% confidence interval [CI], 0.34-2.57) and 0.95 (95% CI, 0.59-1.53). Although an almost doubled risk of ischemic stroke was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage: hazards ratio=1.47 (95% CI, 0.83-2.56). Smoking ≥20 cigarettes per day was clearly associated both with strokes before 45 years of age, hazards ratio=5.04 (95% CI, 2.80-9.06), and with strokes throughout the follow-up, hazards ratio=2.15 (95% CI, 1.61-2.88). Conclusions-We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.

show abstract

mentioning

confidence: 99%

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Falkstedt

Wolff

Allebeck

et al. 2017

Stroke

View full text Add to dashboard Cite

show abstract

“…[1][2][3] Stroke in the young and middle-aged patients has serious consequences. Those <50 years of age are typically vocationally active, and they have families to take care of.…”

mentioning

confidence: 99%

Long-Term Mortality After First-Ever and Recurrent Stroke in Young Adults

Aarnio

Haapaniemi

Melkas

et al. 2014

Stroke

116

View full text Add to dashboard Cite

Background and Purpose-Mortality after first-ever stroke, and particularly after recurrent stroke, and predictors of longterm mortality among young and middle-aged stroke patients are not well-known. We assessed 17-year risk of mortality with focus on the effect of recurrence on the risk of death of young and middle-aged patients with stroke. Methods-Mortality and recurrent stroke rate of 970 consecutive 30-day survivors of first-ever ischemic stroke aged 15 to 49 years (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) were studied. Prospective follow-up data came from the Finnish Care Register for Health Care and Statistics Finland. Mean follow-up was 10.2±4.3 years. We compared survival between clinical subgroups and identified factors associated with mortality. Standardized mortality ratio was calculated for demographic and pathogenetic subgroups using mortality data of the general population matched with age, sex, calendar year, and geographical area. Results-At the end of follow-up, 152 (15.7%) patients had died (cumulative risk, 23.0%; 95% confidence interval, 19.1%-26.9%) and 132 (13.6%) had experienced a recurrent stroke. After adjusting for baseline characteristics, recurrent stroke was statistically the most important risk factor for mortality after first-ever ischemic stroke (hazard ratio, 16.68; 95% confidence interval, 2.33-119.56; P=0.005). Observed mortality was 7-fold higher than the expected mortality (standardized mortality ratio, 6.94; 95% confidence interval, 5.84-8.04) and particularly high among patients who experienced a recurrent stroke (standardized mortality ratio, 14.43; 95% confidence interval, 10.11-18.74). Conclusions-The high mortality rates and the striking impact of recurrent stroke on the risk of death should lead to development of more robust primary and secondary prevention strategies for young patients with stroke. (Stroke. 2014;45:2670-2676.)

show abstract

“…Although there are many important diagnostic laboratory and imaging technologies, the cause and risk factors for young adult stroke are often rare or undetermined [13].…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Recurrent Vascular Events Due to Protein C Deficiency

2015

J Clin Toxicol

View full text Add to dashboard Cite

Protein C deficiency is a rare autosomal dominant disorder with a characteristic of hypercoagulation state and recurrent venous thrombosis in clinics. It is one important cause for youth vascular ishcaemic events including cerebral stroke. However, less attention was focused on the disorder of protein C deficiency so that misdiagnosis is very common. Here, we reported two cases of recurrent vascular ischaemic events due to protein C deficiency. They accepted warfarin and fresh frozen plasma respectively and fully recovered. Our report suggest the importance of early recognition of protein C deficiency in youth with recurrent vascular thrombosis and personalized management should be emphasized.

show abstract

The Growing Problem of Stroke among Young Adults

Cited by 46 publications

References 65 publications

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Long-Term Mortality After First-Ever and Recurrent Stroke in Young Adults

Two Cases of Recurrent Vascular Events Due to Protein C Deficiency

Contact Info

Product

Resources

About