Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults.
Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults.
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DOI：
10.1001/jamaneurol.2017.0020
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发表时间：
2017-06-01
期刊：
影响因子：
29
通讯作者：
Bowman BA
中科院分区：
文献类型：
--
作者：
George MG;Tong X;Bowman BA
虽然中风死亡率在过去二十年中大幅下降，但这一趋势主要局限于老年人。已经注意到年轻人中风发病率和住院率的上升趋势，但人们担心这反映了通过增加影像学使用来提高诊断，而不是代表真正的增加。我们的目的是确定中风住院率是否继续增加，并确定在年轻人中相关中风危险因素的患病率。从1995年到2012年，全国住院病人样本的住院数据被用来分析18-64岁年轻人的急性中风住院率。2003-2012年的住院数据用于确定急性卒中相关危险因素的流行程度。急性卒中住院由主要ICD-9-CM代码确定，相关危险因素由每次住院的次要ICD-9-CM代码确定。按中风类型、年龄、性别和种族/民族划分的急性中风住院率的趋势，以及按中风类型、年龄和性别划分的相关危险因素的流行率。本研究的主要发现是：1)18-54岁的年轻成人中，缺血性卒中住院率在男性和女性以及某些种族/民族群体中均显著增加，18-34岁和35-44岁的男性住院率自1995-96年以来几乎翻了一番，其中35-44岁的男性增加了41.5%；2)从2003-04年到2011-12年，18-64岁的男性和女性因急性缺血性卒中住院的患者中卒中危险因素的患病率持续上升；3)在经历急性缺血性中风的年轻人中，具有多种危险因素的患病率在过去十年中几乎翻了一番。脑出血和蛛网膜下腔出血的住院率保持稳定。青壮年急性缺血性卒中住院率上升与传统卒中危险因素患病率上升并存，这一发现证实了关注青壮年预防的重要性。
While stroke mortality rates have decreased substantially in the past two decades, this trend has been primarily limited to older adults. Increasing trends in stroke incidence and hospitalizations have been noted among younger adults, but there has been concern that this reflected improved diagnosis through an increased use of imaging rather than representing a real increase. We aimed to determine whether stroke hospitalization rates have continued to increase and to identify the prevalence of associated stroke risk factors among younger adults. Hospitalization data from the National Inpatient Sample from 1995 through 2012 were used to analyze acute stroke hospitalizations rates among young adults aged 18–64. Hospitalization data from 2003–2012 were used to identify the prevalence of associated risk factors for acute stroke. Acute stroke hospitalizations were identified by the principal ICD-9-CM code and associated risk factors were identified by secondary ICD-9-CM codes for each hospitalization. Trends in acute stroke hospitalization rates by stroke type, age, sex, and race/ethnicity, as well as the prevalence of associated risk factors by stroke type, age, and sex. The major findings in this study are 1) ischemic stroke hospitalization rates increased significantly for both males and females and for certain race/ethnic groups among younger adults aged 18–54 and have almost doubled for males aged 18–34 and 35–44 years since 1995–96, with a 41.5% increase among males aged 35–44; 2) the prevalence of stroke risk factors among those hospitalized for acute ischemic stroke continued to increase from 2003–04 through 2011–12 for both males and females aged 18–64; and 3) the prevalence of having multiple risk factors among younger adults experiencing an acute ischemic stroke has nearly doubled over the decade. Hospitalization rates for intracerebral hemorrhage and subarachnoid hemorrhage remained stable. The identification of increasing hospitalization rates for acute ischemic stroke in young adults coexistent with increasing prevalence of traditional stroke risk factors confirms the importance of focusing on prevention in younger adults.
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影响因子：
8.3
作者：
BEVAN, H;SHARMA, K;BRADLEY, W
通讯作者：
BRADLEY, W
影响因子：
5.4
作者：
Ramirez L;Kim-Tenser MA;Sanossian N;Cen S;Wen G;He S;Mack WJ;Towfighi A
通讯作者：
Towfighi A
影响因子：
8.3
作者：
Mitchell AB;Cole JW;McArdle PF;Cheng YC;Ryan KA;Sparks MJ;Mitchell BD;Kittner SJ
通讯作者：
Kittner SJ
影响因子：
11
作者：
Bejot, Yannick;Daubail, Benoit;Giroud, Maurice
通讯作者：
Giroud, Maurice
影响因子：
29
作者：
Ji, Ruijun;Schwamm, Lee H.;Singhal, Aneesh B.
通讯作者：
Singhal, Aneesh B.