(RxWiki News) Stroke is often thought of as a condition that affects older people. While the rate of stroke deaths has dropped over 20 years, strokes among young and middle-aged people have steadily risen.
New research found that worldwide, a growing number of young and middle-aged people are affected by stroke, and stroke-related illnesses, disabilities and premature deaths are expected to more than double by 2030.
"Quit smoking to reduce stroke risk."
Valery Feigin, MD, professor of epidemiology and neurology and director of the National Institute for Stroke and Applied Neurosciences at Auckland University of Technology in New Zealand, collaborated with an international team of scientists in reviewing 119 studies on stroke burden from 1990 to 2010.
Collected from 21 regions around the world, results reflected 58 high-income countries and 61 low-income countries.
Over the decades reviewed, the number of new strokes increased 68 percent, the number of stroke survivors rose by 84 percent, and disability and illness linked to stroke went up by 12 percent.
The researchers found that the number of stroke cases among people aged 20 to 64 years climbed by 25 percent over 20 years. Before 1990, a quarter of all strokes were in this age group. By 2010, that percentage rose to almost one-third.
Among those who have had a stroke, people under 74 years old account for 62 percent of new strokes, 45 percent of deaths and 72 percent of illness and disability, according to the authors.
In terms of actual numbers, 16.9 million had a first stroke, 33 million survived stroke and 5.9 million died from stroke-related causes in 2010.
In general, people in high-income countries fared better than those in low-income areas. For those in high-income regions, stroke incidence dipped by 12 percent, premature death dropped by 37 percent and disability rates declined 36 percent.
The researchers suspected that improved education, prevention and care led to these improved results.
Low-income countries were harder hit. Compared to high-income countries, stroke-related deaths were 42 percent higher and rates of disability and illness was 46 percent greater.
Although this study was not designed to look at the reasons for increased stroke in younger people, Dr. Feigin told dailyRx News, “People of this younger age group have been increasingly exposed to the risk factors of stroke.
"Specifically, people from low- to middle-income countries have been increasingly exposed to a Westernized lifestyle that includes fast food, an unbalanced diet and a diet with lots of salt and saturated fats," said Dr. Feigin. "This leads to increased blood pressure and other cardiovascular complications, including diabetes and excess body weight, all of which increase likelihood of stroke. In young and middle aged adults, evidence from other research points to an epidemic of obesity and diabetes; this is clearly one of the main risk factors for stroke.”
Dr. Feigin and colleagues also discovered that hemorrhagic strokes, which are half as common as ischemic strokes, accounted for three fifths of disability and just over half of the lives lost to stroke.
An ischemic stroke occurs when an artery to the brain gets blocked, whereas a hemorrhagic stroke occurs when a weakened blood vessel ruptures. Unhealthy diet, high blood pressure, obesity, physical inactivity and smoking are all factors that can lead to stroke.
The researchers noted that 0.5 percent of all strokes are in people aged 20 and younger.
"For children [up to 19 years old], risk factors for stroke are quite different than risk factors for young and middle-aged people [20 to 64 years]. These include congenital heart and vascular disorders, blood diseases and infections," Dr. Feigin said.
In a related commentary published in The Lancet Global Health, Graeme Hankey, MD, a neurologist and clinical professor at the University of Western Australia in Perth, wrote, “Population-based mass strategies to reduce consumption of salt, calories, alcohol, and tobacco by improving education and the environment will complement high-risk strategies of identifying those at risk of hemorrhagic (and ischemic) stroke, thus empowering these individuals to improve their lifestyle behaviors and, if necessary, lower their mean blood pressure and blood pressure variability with appropriate doses of antihypertensive drugs."
This research was published online October 24 in studies in The Lancet and The Lancet Global Health.