Stroke in the Young Levels Off; Racial Disparity Continues, Researchers Say

Brett Kissela, MD, in his academic office on the UC Academic Health Center campus.
Photo by Cindy Starr for UCNI.

CONTACT: Keith Herrell
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CINCINNATI—The trend of increasing stroke in the young appears to have leveled off slightly but remains a significant public health issue, new research from the University of Cincinnati indicates.

In addition, racial disparity in stroke incidence continues to be unchanged over time, as blacks have significantly higher rates of strokes than whites, researchers found.

The research, based on data from Greater Cincinnati and Northern Kentucky, is being presented Thursday, Feb. 13, at the American Heart Association/American Stroke Association’s annual International Stroke Conference 2014 in San Diego. The conference is the world’s largest meeting dedicated to the science and treatment of cerebrovascular disease.

Brett Kissela, MD, Albert Barnes Voorheis Chair of Neurology and Rehabilitation medicine at UC and a UC Health neurologist, gave an oral presentation on stroke in the young that further described trends reported from the study periods 1993-94, 1999 and 2005 by adding preliminary figures from 2010. Previously, research led by Kissela had reported that stroke incidence in the young had significantly increased over the three study periods between 1993 and 2005, with average age of first stroke falling from 71.3 in 1993-94 to 70.9 in 1999 and 68.4 by 2005.

The average age of first stroke in 2010 was 68.5, Kissela reports, indicating that the trend is leveling off. Additionally, the proportion of all strokes under age 45 fell to 6.1 percent after rising in the three previous study periods from 4.6 percent to 5.4 percent and 7.3 percent, respectively.

“While the trend seems to have leveled off slightly, stroke in the young is still of great public health significance as younger strokes carry the potential for a greater lifetime burden of disability,” Kissela says.

Further study of the issue is needed, says Kissela, who notes that the increased prevalence of diabetes, hypertension and obesity is likely a major contributor.

Racial Disparity Not Improving

Also today, Dawn Kleindorfer, MD, a professor of neurology and rehabilitation medicine at UC and co-director of the UC Stroke Team, presented a poster showing that while stroke incidence has stabilized, racial disparity is not improving. Blacks had a substantially increased incidence of stroke compared to whites in all study periods evaluated, the research showed.

Not only do blacks have almost twice the risk of first-ever stroke compared with whites, the American Stroke Association says, but blacks 35-54 years old have four times the relative risk for stroke.

“It’s disappointing that the racial disparity in stroke is not improving at all over time,” says Kleindorfer, who adds that more research into root causes for the disparity is needed.

Kissela and Kleindorfer are both members of the UC Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health. Their research is part of the Greater Cincinnati/Northern Kentucky Stroke Study, which identifies all hospitalized and autopsied cases of stroke and transient ischemic attack (TIA) in a five-county region. Funding comes from the National Institute of Neurological Disorders and Stroke, with a current grant award of $6.8 million over five years.

Stroke is the No. 4 cause of death and a leading cause of disability in the United States, according to the American Stroke Association.

“It’s important to track what happens over time to see how stroke is changing by age, race and gender,” Kissela says.  “The more we understand stroke, the better off we’ll be.”

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