LOS ANGELES (AP) — Strokes are rising dramatically among young and middle-aged Americans while dropping in older people, a sign that the obesity epidemic may be starting to shift the age burden of the disease.
The numbers, reported Wednesday at an American
Stroke Association conference, come from the first large nationwide study of
stroke hospitalizations by age. Government researchers compared
hospitalizations in 1994 and 1995 with ones in 2006 and 2007.
The sharpest increase — 51 percent — was among men
15 through 34. Strokes rose among women in this age group, too, but not as fast
— 17 percent.
"It's definitely alarming," said Dr.
Ralph Sacco, American Heart Association president and a neurologist at the
University of Miami. "We have worried for a while that the increased
prevalence of obesity in children and young adults may take its toll in
cardiovascular disease and stroke," and that appears to be happening, he
said.
Stroke still takes its highest toll on older
people. For those over 65, there were nearly 300 stroke cases among 10,000
hospitalizations in the more recent period studied. For males 15 to 34, there
were about 15 stroke cases per 10,000, and for girls and women in that age
group there were about 4 per 10,000.
Several small studies had recently suggested an
ominous rise among the young and among middle-aged women.
"We were interested in whether we could pick
that up in a much larger, nationwide dataset," said Dr. Mary George, a
stroke researcher at the U.S. Centers for Disease Control and Prevention.
The researchers examined federal records from a
sample of hospitals in 41 states, covering about 8 million cases each year.
They looked at the percentage of all hospitalizations for stroke by gender and
in six age groups.
For every 10,000 hospitalizations in 1994-95
compared with 2006-07, strokes rose:
—51 percent, from 9.8 to 14.8, among males 15 to 34
years old
—17 percent, from 3.6 to 4.2, in females 15 to 34
—47 percent, from 36 to 52.9, in males 35 to 44
—36 percent, from 21.9 to 30, in females 35 to 44
"The increases seen in children are very
modest, but they are more so in the young adult age groups, and we feel that
deserves further study," George said.
Better awareness of stroke symptoms and better
imaging methods for detecting strokes in young people could account for some of
that change, but there is no way to know, she said.
Trends went the opposite way in older people.
Strokes dropped 25 percent among men 65 and older (from 404 to 303 per 10,000
hospitalizations), and 28 percent among women in this age group (from 379 to
274). Doctors think better prevention and treatment of risk factors such as
high blood pressure in older people may be contributing to the decline.
At the University of California at Los Angeles,
doctors are seeing more strokes related to high blood pressure and clogged
arteries in younger people, said Dr. Jeffrey Saver, director of the stroke
center at UCLA.
Early estimates from 2007 death certificates
suggest that stroke is now the nation's fourth leading cause of death instead
of the third, partly because of better treatments and prevention among the
elderly. "But at the same time we're seeing this worrisome rise in
mid-life," Saver said.
Allison Hooker, a nurse who coordinates stroke care
at Forsyth Medical Center in Winston-Salem, N.C., said her hospital also is
seeing more strokes in younger people with risk factors such as smoking,
obesity, high blood pressure, alcohol overuse and diabetes.
"I'd say at least half of our population (of stroke
patients) is in their 40s or early 50s," she said, "and devastating
strokes, too."
Also at the conference:
—A preliminary study raised concern about diet soda
and stroke risk. Researchers surveyed about 2,500 adults in the New York City
area at the start of the study and followed their health for nearly 10 years
afterward. Researchers found that people who said they drank diet soda every
day had a 48 percent higher risk of stroke or heart attack than people who
drank no soda of any kind. Researchers adjusted for differences in other risk
factors, such as smoking and high blood pressure.
Lead researcher Hannah Gardener of the University
of Miami had no explanation for the findings but said that for those trying to
cut calories, "diet soft drinks may not be an optimal substitute for
sugar-sweetened beverages."
—The same study also found higher risks for people
consuming more than 1,500 milligrams of salt a day — the limit the American
Heart Association recommends. Researchers found that stroke risk rose 16
percent for every 500 milligrams of salt consumed each day. Those who took in
at least 4,000 milligrams had a more than 2.5 times higher risk of stroke than
those who limited themselves to 1,500 milligrams.
A teaspoon of salt contains about 2,300 milligrams
of sodium. About three-fourths of the salt we eat, though, comes from processed
foods, especially tomato sauce, soups, condiments and canned foods.
Copyright
2011 The Associated Press.
