Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults
Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults
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DOI：
10.1161/strokeaha.117.016599
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发表时间：
2017-07-01
期刊：
影响因子：
8.3
通讯作者：
Busch, Markus A.
中科院分区：
文献类型：
--
作者：
Aigner, Annette;Grittner, Ulrike;Busch, Markus A.
背景和目的：与老年人群相比，年轻人中风被认为具有不同的病因和危险因素，本研究的目的是研究已确定的潜在可改变的心血管危险因素对年轻人中风负担的影响。方法：对2007年至2010年SIFAP1研究（年轻法布里患者卒中）的患者和2009年至2010年基于人群的GEDA研究（德国健康更新）的对照组进行了一项德国全国性病例对照研究。病例是来自26个临床卒中中心的2125例年龄在18至55岁的急性首次卒中患者；对照组（年龄和性别匹配，n=8500，无卒中史）来自全国社区样本。计算所有脑卒中、缺血性脑卒中和原发性脑出血的8个危险因素（高血压、高脂血症、糖尿病、冠心病、吸烟、间歇性大量饮酒、低体力活动和肥胖）及其组合的调整人群归因风险。结果：低体力活动和高血压是最重要的危险因素，分别占所有卒中的59.7%（95%可信区间为56.3 ~ 63.2）和27.1%（95%可信区间为23.6 ~ 30.6）。所有8种危险因素加起来解释78.9%（95%可信区间，76.3-81.4）的卒中。所有缺血性卒中亚型中所有危险因素的人群归因风险相似。大多数危险因素的人口归因风险在老年群体和男性中较高。结论：先前在老年人群中确定的可改变的危险因素也占了年轻人中风的很大一部分，4个危险因素解释了几乎80%的中风风险。
Background and Purpose-As stroke in young adults is assumed to have different etiologies and risk factors than in older populations, the aim of this study was to examine the contribution of established potentially modifiable cardiovascular risk factors to the burden of stroke in young adults.Methods-A German nationwide case-control study based on patients enrolled in the SIFAP1 study (Stroke In Young Fabry Patients) 2007 to 2010 and controls from the population-based GEDA study (German Health Update) 2009 to 2010 was performed. Cases were 2125 consecutive patients aged 18 to 55 years with acute first-ever stroke from 26 clinical stroke centers; controls (age-and sex-matched, n=8500, without previous stroke) were from a nationwide community sample. Adjusted population-attributable risks of 8 risk factors (hypertension, hyperlipidemia, diabetes mellitus, coronary heart disease, smoking, heavy episodic alcohol consumption, low physical activity, and obesity) and their combinations for all stroke, ischemic stroke, and primary intracerebral hemorrhage were calculated.Results-Low physical activity and hypertension were the most important risk factors, accounting for 59.7% (95% confidence interval, 56.3-63.2) and 27.1% (95% confidence interval, 23.6-30.6) of all strokes, respectively. All 8 risk factors combined explained 78.9% (95% confidence interval, 76.3-81.4) of all strokes. Population-attributable risks of all risk factors were similar for all ischemic stroke subtypes. Population-attributable risks of most risk factors were higher in older age groups and in men.Conclusions-Modifiable risk factors previously established in older populations also account for a large part of stroke in younger adults, with 4 risk factors explaining almost 80% of stroke risk.