Overall, stroke mortality rates in the United States are declining. Nonetheless, as the incidence of stroke risk factors such as high blood pressure, obesity, and diabetes has increased among Americans under the age of 64, so too, has the number of stroke hospitalizations.
A stroke occurs when there is a decrease in the blood flow to the brain. A stroke can be caused by a rupture (hemorrhagic stroke) or a blood clot (ischemic stroke) in an artery supplying blood to the brain. When this happens, the resulting lack of oxygen to the brain can cause cells to die, leading to impaired function. How a person is affected by a stroke depends upon the functions performed by the area of the brain affected.
In a study published this month in JAMA Neurology, Dr. Mary George and her team from Atlanta, GA analyzed hospital discharge and billing data from the years 2003 through 2012 for acute ischemic stroke hospitalizations for adults between 18 and 65 years of age. Data was gathered from the National Inpatient Sample (NIS) which is part of the Healthcare Cost and Utilization Project. Data for hospitals in 37 states was gathered in 2003. This increased each year so that, by 2012, hospitals in 44 states were represented.
They found that between 2003 and 2012, ischemic stroke hospitalization rates increased significantly for both men and women, and for certain race and ethnic groups in the 18-54 age range. The biggest surge in ischemic stroke rates occurred in the 35-44 age group. Since 1995-1996, ischemic stroke rates almost doubled for men aged 18-34 and 35-54, while the rate for women aged 55-64 remained constant. Rates for non-Hispanic black individuals aged 18-34 also remained constant.
The researchers did not feel that these findings were due to increased use of imaging. As such, they analyzed the data according to stroke risk factors. While tobacco smoking declined over the past decade, other stroke risk factors (high blood pressure, obesity, diabetes, and hypercholesterolemia) have either remained constant or increased significantly. In addition, they found that the prevalence among young adults of having multiple traditional stroke risk factors has doubled since 2003.
Strokes are a serious but largely preventable disease. The significant increases in ischemic stroke hospitalizations and the prevalence of traditional stroke risk factors are a call to action. Effective prevention strategies would not only improve the quality of life for many individuals, it would also reduce disability, reduce health costs, and save lives.
Written By: Debra A. Kellen, PhD