TRADITIONAL RISK-FACTORS AND ISCHEMIC STROKE IN YOUNG-ADULTS - THE BALTIMORE-WASHINGTON COOPERATIVE YOUNG STROKE STUDY

Objective: To determine the association of hypertension, diabetes, and cigarette smoking with incidence of ischemic stroke in young adults. Design: Case-control study. Setting: Population-based sample of cases and controls. Subjects: The study included 296 cases of incident ische mic stroke among black and white adults aged 18 to 44 years in central Maryland counties from the Baltimore-Washington Cooperative Young Str oke Study and 1220 black and white adults aged 18 to 44 years from the Maryland Behavioral Risk Factor Survey, a telephone survey of a rando m sample of the same region, to serve as controls. Main Outcome Measur es: Logistic regression models were developed to determine the age-adj usted odds ratios for each risk factor. Population-attributable risk p ercents were computed based on the odds ratios and prevalence of each risk factor. Results: The age-adjusted odds ratios (95% confidence int ervals) for white men (WM), white women (WW), black men (BM), and blac k women (BW) were as follows: current cigarette smoking: WM, 2.0 (1.1- 3.8), WW, 2.1 (1.1-4.3), BM, 3.3 (1.6-6.6), and BW, 2.2 (1.3-3.9); his tory of diabetes mellitus: WM, 22.9 (5.8-89.6), WW, 6.2 (1.9-20.2), BM , 4.2 (0.8-21.9), and BW, 3.3 (1.4-7.7); and history of hypertension: WM, 1.6 (0.7-3.2), WW, 2.5 (1.1-5.9), BM, 3.8 (1.8-7.9), and BW, 4.2 ( 2.4-7.5). The population-attributable risk percents (95% confidence in tervals) were as follows: current cigarette smoking: WM, 22.6 (3.1-38. 2), WW, 17.2 (4.0-34.0), BM, 40.5 (23.1-54.0), and BW, 29.1 (13.5-41.9 ); history of diabetes mellitus: WM, 19.0 (8.2-28.5), BW, 15.8 (3.8-26 .3), BM, 13.2 (5.3-20.4), and BW, 22.1 (12.5-30.7); and history of hyp ertension: WM, 21.7 (6.2-34.6), WW, 21.3 (5.4-34.5), BM, 53.5 (39.0-64 .4), and BW, 50.5 (37.1-61.1). Conclusions: Hypertension, diabetes mel litus, and current cigarette smoking are important risk factors in a b iracial young adult population. Cigarette smoking and hypertension, th e 2 most modifiable risk factors, were particularly important risk fac tors in young blacks.