RISK-FACTORS FOR STROKE DUE TO CEREBRAL INFARCTION IN YOUNG-ADULTS

Background and Purpose Stroke in the young is particularly tragic beca use of the potential for a lifetime of disablement. More than 10% of p atients with stroke due to cerebral infarction are aged 55 years or yo unger. While a number of studies have addressed the issue of stroke me chanism in the young, quantitation of risk factors has rarely been und ertaken. Given the importance of risk factor assessment in primary pre vention, we aimed to assess this using case-control methodology in a h ospital-based series and community-based control subjects. Methods A t otal of 201 consecutive patients with first-onset stroke due to cerebr al infarction aged 15 to 55 years (mean, 45.5 years) were accrued from four teaching hospitals during 1985 to 1992 and compared with their a ge-and sex-matched neighborhood controls. Information concerning poten tial risk factor exposure status was collected by structured questionn aire at interview. Stroke risks were estimated by calculating the odds ratios with multivariate logistic regression. Results Significantly i ncreased risk of stroke was found among those with diabetes (odds rati o, 11.6 [95% confidence intervals, 1.2 to 115.2]), hypertension (6.8 [ 3.3 to 13.9]), heart disease (2.7 [1.1 to 6.4]), current cigarette smo king (2.5 [1.3, 5.0]), and long-term heavy alcohol consumption (greate r than or equal to 60 g/d) (15.3 [1.0 to 232.0]). However, heavy alcoh ol ingestion (greater than or equal to 60 g) within 24 hours preceding stroke onset was not a risk factor (0.9 [0.3 to 3.4]). Conclusions Di abetes, hypertension, heart disease, current smoking, and long-term he avy alcohol consumption are major risk factors for stroke in young adu lts. Given that the majority of these factors are either correctable o r modifiable, prevention strategies may have the potential to reduce t he impact of stroke in this age group.