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Young adults increasingly prone to strokes

News Desk (The Jakarta Post)
Jakarta
Sat, October 7, 2017

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Young adults increasingly prone to strokes A study in 'JAMA Neurology' published in June found that ischemic stroke hospitalization rates are increasing for both men and women under the age of 45. (Shutterstock/File)

Y

oung adults generally disregard certain health screening tests, believing they don’t need them until they are older, such as tests for cholesterol, blood pressure and blood sugar. A recent study, however, has found that stroke hospitalization rates for younger adults has increased.

A study in JAMA Neurology published in June found that hospitalization rates for ischemic stroke, which occurs when a blood vessel carrying blood to the brain is blocked by a blood clot, are increasing for both men and women under the age of 45.

The analysis found that hospitalization rates for acute ischemic stroke in women aged 18 to 34 rose by 31.8 percent, from 4.4 per 10,000 hospitalizations in 2003 to 2004, up to 5.8 per 10,000 hospitalizations in 2011 to 2012.

Meanwhile, the rate in women aged 35 to 44 rose by 30 percent, from 27.5 to 35.8 per 10,000 hospitalizations.

As reported by SELF, screening tests are important to give physicians a good idea of the risk of stroke in young adults, according to neurologist Diana Greene-Chandos, director of neurocritical care at the Ohio State University Wexner Medical Center.

"Compared to 20 years ago, the incidence of stroke is rising in young adults to a significant degree," she told SELF.

The use of contraceptives is among the factors that drive the increase in numbers for women, as hormonal birth control methods have been associated with a slightly increased risk of blood clots. However, while blood clots account for 87 percent of all strokes, the absolute risk of blood clots while on birth control remains low.

Read also: Lack of sleep boosts chance of death by heart failure

Another factor suggested includes smoking, which would also raise the risk of stroke.

Neurologists, however, have mostly pointed to large increases in common stroke risk factors as the reason, which include hypertension, lipid disorders, diabetes, tobacco use and obesity.

The study in JAMA Neurology found that the range of absolute increases for each factor varies, but noted they are all on the upswing.

Lipid disorders, also known as high cholesterol, is increasing the most, as it rose from 12 percent to 21 percent. The prevalence of a woman under 45 having three to five risk factors has more than doubled.

"Clearly, something big is happening with stroke and young people," Green-Chandos said, adding that people still think that a stroke just doesn't happen to people under the age of 45.

Speaking to SELF, Koto Ishida, M.D. and director of NYU Langone's Comprehensive Stroke Center, noted that stroke risk is actually decreasing for older adults.

The JAMA Neurology study found that hospitalization for stroke in women aged 55 to 64 actually decreased by 2.2 percent, dropping from 173.4  to 169.5 per 10,000 hospitalizations.

Ishida said the same risk factors that were increasing in young people, such as cholesterol and blood pressure, were usually being managed in those over the age of 50.

"Older adults expect to have these kind of issues, so they get screened," Ishida said, noting that someone in their 20s usually didn't think about such issues unless there was a problem.

Read also: The stroke miracle cure you probably can't get

Know the signs

The acronym FAST -- which stands for Face, Arm, Speech, Time -- is commonly taught to identify the signs when a stroke is occurring.

As a stroke is happening in the brain, usually one side of the body is affected, which causes someone's face on that side to sag and also leads to problems with raising that side's arm.

A stroke may also be affecting memory and verbal abilities, causing slurred or confused speech. 

Time is crucial at this point and anti-stroke medication must be given within four hours of a stroke onset to prevent permanent disability or death.

However, Dr. Greene-Chandos says not all strokes look like the classic FAST incident. Older adults tend to be affected by larger blood vessels, making them more likely to have "major stroke symptoms" like drooping faces.

Younger people, meanwhile, tend to have blood clots from other areas of the body and blood clots that can move through smaller blood vessels.

Read also: Cholesterol drug reduces death in men without heart disease

Greene-Chandos said the difference could lead to symptoms in the form of numbness or headache.

She added that women having a stroke are also more likely to have debilitating headaches and that people who suffer from regular migraines are actually at a greater risk for strokes in general.

She further noted that hiccups that don't resolve could also be a stroke symptom.

“It’s possible to have a small stroke and not realize it,” Greene-Chandos said. “You could even have multiple strokes and have no outward symptoms. But over time, the changes in your brain could affect your memory and speech significantly.”

Greene-Chandos noted the importance of regular health checks, even if someone thinks they're too young or healthy, saying that it's important to know the symptoms, especially if you carry other stroke risk factors.

“Know your numbers. And most of all, don’t think that strokes are just for older people. That’s simply not the case,” she said. (liz/kes)

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