Demographic and Geographic Vascular Risk Factor Differences in European Young Adults With Ischemic Stroke: The 15 Cities Young Stroke Study.
Putaala, Jukka MD, PhD; Yesilot, Nilufer MD; Waje-Andreassen, Ulrike MD, PhD; Pitkaniemi, Janne PhD(Stat); Vassilopoulou, Sofia MD, PhD; Nardi, Katiuscia MD, PhD; Odier, Celine MD; Hofgart, Gergely MD; Engelter, Stefan MD; Burow, Annika MD; Mihalka, Laszlo MD; Kloss, Manja MD; Ferrari, Julia MD; Lemmens, Robin MD, PhD; Coban, Oguzhan MD; Haapaniemi, Elena MD, PhD; Maaijwee, Noortje MD; Rutten-Jacobs, Loes MSc; Bersano, Anna MD, PhD; Cereda, Carlo MD; Baron, Pierluigi MD; Borellini, Linda MD; Valcarenghi, Caterina MD; Thomassen, Lars MD, PhD; Grau, Armin J. MD, PhD; Palm, Frederick MD; Urbanek, Christian MD; Tuncay, Rezzan MD; Durukan-Tolvanen, Aysan MD; van Dijk, Ewoud J. MD, PhD; de Leeuw, Frank-Erik MD, PhD; Thijs, Vincent MD, PhD; Greisenegger, Stefan MD; Vemmos, Konstantinos MD; Lichy, Christoph MD, MSc; Bereczki, Daniel MD, DSc; Csiba, Laszlo MD, PhD; Michel, Patrik MD; Leys, Didier MD, PhD; Spengos, Konstantinos MD, PhD; Naess, Halvor MD, PhD; Bahar, Sara Zarko MD; Tatlisumak, Turgut MD, PhD
43(10):2624-2630, October 2012.
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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.
(C) 2012 American Heart Association, Inc.