Demographic and geographic vascular risk factor differences in european young adults with ischemic stroke

Background and Purpose—We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe.Methods—We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital- or popula...

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Main Authors: Putaala, Jukka (Author) , Kloss, Manja (Author) , Lichy, Christoph (Author)
Format: Article (Journal)
Language:English
Published: 12 Jul 2012
In: Stroke
Year: 2012, Volume: 43, Issue: 10, Pages: 2624-2630
ISSN:1524-4628
DOI:10.1161/STROKEAHA.112.662866
Online Access:Verlag, Volltext: http://dx.doi.org/10.1161/STROKEAHA.112.662866
Verlag, Volltext: https://www.ahajournals.org/doi/10.1161/STROKEAHA.112.662866
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Author Notes:Putaala Jukka, Yesilot Nilufer, Waje-Andreassen Ulrike, Pitkäniemi Janne, Vassilopoulou Sofia, Nardi Katiuscia, Odier Celine, Hofgart Gergely, Engelter Stefan, Burow Annika, Mihalka Laszlo, Kloss Manja, Ferrari Julia, Lemmens Robin, Coban Oguzhan, Haapaniemi Elena, Maaijwee Noortje, Rutten-Jacobs Loes, Bersano Anna, Cereda Carlo, Baron Pierluigi, Borellini Linda, Valcarenghi Caterina, Thomassen Lars, Grau Armin J., Palm Frederick, Urbanek Christian, Tuncay Rezzan, Durukan-Tolvanen Aysan, van Dijk Ewoud J., de Leeuw Frank-Erik, Thijs Vincent, Greisenegger Stefan, Vemmos Konstantinos, Lichy Christoph, Bereczki Daniel, Csiba Laszlo, Michel Patrik, Leys Didier, Spengos Konstantinos, Naess Halvor, Bahar Sara Zarko, Tatlisumak Turgut

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520 |a Background and Purpose—We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe.Methods—We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital- or population-based prospective or consecutive young stroke registries involving 15 cities in 12 countries. Geographic regions were defined as northern (Finland, Norway), central (Austria, Belgium, France, Germany, Hungary, The Netherlands, Switzerland), and southern (Greece, Italy, Turkey) Europe. Hierarchical regression models were used for comparisons.Results—In the study cohort (n=3944), the 3 most frequent risk factors were current smoking (48.7%), dyslipidemia (45.8%), and hypertension (35.9%). Compared with central (n=1868; median age, 43 years) and northern (n=1330; median age, 44 years) European patients, southern Europeans (n=746; median age, 41 years) were younger. No sex difference emerged between the regions, male:female ratio being 0.7 in those aged <34 years and reaching 1.7 in those aged 45 to 49 years. After accounting for confounders, no risk-factor differences emerged at the region level. Compared with females, males were older and they more frequently had dyslipidemia or coronary heart disease, or were smokers, irrespective of region. In both sexes, prevalence of family history of stroke, dyslipidemia, smoking, hypertension, diabetes mellitus, coronary heart disease, peripheral arterial disease, and atrial fibrillation positively correlated with age across all regions.Conclusions—Primary preventive strategies for ischemic stroke in young adults—having high rate of modifiable risk factors—should be targeted according to sex and age at continental level. 
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