Most strokes are caused by traditional stroke risk factors such as high blood pressure, high cholesterol, type 2 diabetes, smoking, obesity, low physical activity, alcohol abuse, and coronary heart disease. However, research shows that recent data show that the incidence of stroke is increasing even among young adults who do not have these risk factors.

“We wanted to understand which risk factors contribute most to stroke risk in young adults,” said study lead author Michelle Reppert, MD, assistant professor of neurology at the University of Colorado School of Medicine in Aurora. MSc, MBA, FAHA said. , Colorado.

Using an administrative database of health insurance claims reported in Colorado, researchers matched data from more than 2,600 people who had a stroke with data from more than 7,800 people who did not have a stroke, and determined which risk factors We identified which are most likely to cause a stroke.

This analysis shows that non-traditional stroke risk factors such as migraines, blood clotting disorders, renal failure, autoimmune diseases, and malignancies are significantly associated with the development of stroke in men and women aged 18 to 44 years. It has been found. The association between stroke and nontraditional stroke risk factors was stronger in adults younger than 35 years.

The results also showed that:

• Among people aged 18 to 34, stroke was more likely to be associated with non-traditional risk factors (approximately 31% for men and approximately 43% for women) than for traditional risk factors (approximately 25% for men and over 33% for women). Ta.
• Migraine is the most important non-traditional risk factor for stroke between the ages of 18 and 34, accounting for 20% of strokes in men and almost 35% in women.
• The contribution of traditional stroke risk factors peaked in adults aged 35 to 44 years and was associated with approximately 33% of strokes in men and 40% in women.
• In the 45-55 age group, non-traditional risk factors accounted for more than 19% of strokes in men and nearly 28% in women.
• Hypertension is the most important traditional risk factor for stroke between the ages of 45 and 55, accounting for 28% of strokes in men and approximately 27% in women.
• Additional traditional and nontraditional risk factors were associated with increased risk of stroke in all genders and age groups.

“These findings are important because most of our attention has focused on traditional risk factors,” Reppert said. “We should not focus solely on traditional risk factors while ignoring non-traditional stroke risk factors; both are important for the development of stroke in young people.

“In fact, the younger you are at the time of stroke, the more likely non-traditional risk factors are to cause stroke,” she says. “Developing targeted interventions requires a deeper understanding of the mechanisms underlying these non-traditional risk factors.”

Researchers were surprised to find that non-traditional risk factors were just as important as traditional risk factors in the development of stroke in young men and women. Reppert added that it was also unexpected that migraine contributed significantly to the development of stroke.

“While there have been many studies demonstrating a link between migraine and stroke, to our knowledge this study may be the first to demonstrate how much of the risk of stroke is due to migraine. No,” Reppert said.

Research details, background and design:

• Researchers collected data from 2012 to 2019 from the Colorado All-Payer Claims Database, which requires submission of all commercial insurance, Medicaid, and Medicare claims.
• Of the stroke cases studied among adults aged 18 to 55, 52% were women and more than 73% were ischemic (thrombotic) strokes, which occur when blood vessels supplying the brain become occluded. Ta.
• Individual race and ethnicity based on insurance reports was missing for nearly half of all participants.
• Data on stroke cases and people who actually had a stroke were matched by gender, age, insurance type, and time period before stroke.
• Cases were defined as patients admitted with a primary diagnosis of ischemic stroke, hemorrhagic stroke, or subarachnoid hemorrhage (bleeding in the space around the brain).
• Non-traditional stroke risk factors are defined as factors that rarely cause stroke in the elderly or are unique to young people, including migraines, malignancies, HIV, hepatitis, thrombophilia (deep venous (including history of thrombosis and pulmonary embolism), autoimmune disease, vasculitis, sickle cell disease, valvular heart disease, and renal failure. Hormonal risk factors, such as oral contraceptive use and pregnancy, were considered separately for each woman.
• Traditional stroke risk factors are defined as well-established potential causes of stroke that are routinely considered for adults aged 65 and older, including hypertension, type 2 diabetes, high cholesterol, sleep apnea, peripheral Arterial disease, atrial fibrillation, coronary artery disease, alcohol abuse, drug abuse, smoking, obesity, congestive heart failure.

This study had several limitations, including reliance on an administrative database that could affect how risk factors were identified, and missing data on race and ethnicity for many participants. Ta. Additionally, this study was conducted in a metropolitan area more than a mile above sea level, so some elevations may have unique conditions that may not apply to people living at other elevations.