The chances of young adults having a stroke from uncommon risks are more than double those of traditional risk factors. This is according to a new study recently published in the peer-reviewed journal, Stroke. The rate of ischemic strokes among adults under 50 years of age is increasing. It appears to be propelled by a rise in cryptogenic strokes in adults who don’t have the common risk factors like obesity, type 2 diabetes, and high blood pressure. Up to 50% of all ischemic strokes among adults 18 to 49 years of age are from unknown causes. They are also more common in women. But what is the cause of the rise in strokes in young women?
The Rise of Strokes In Young Women
For the study, researchers examined the data of more than 1,000 adult European participants aged 18 to 49. Half of these participants had no history of stroke, and the other half had suffered cryptogenic ischemic stroke. Cryptogenic strokes are defined as strokes with unknown causes. The researchers analyzed the associations of 10 nontraditional risk factors, 12 nontraditional risk factors, and five female-specific risk factors. They also focused on participants who were known to have PFO, a heart defect characterized by a hole between the upper chambers of the heart. This type of heart defect is typically harmless, but can increase stroke risk. The aim of the study was to find out which risk factors were mostly responsible for the strokes with unknown causes.
Results of the Analysis
The study found that traditional risk factors were significantly associated with stroke in men and women who did not have a PFO. However, nontraditional risk factors were more associated with stroke among those participants with PFOs. These risk factors included migraine with aura, chronic liver disease, cancer, vein blood clots, and chronic kidney disease. Each additional risk increased the risk of stroke by 41% in participants without a PFO. Each nontraditional risk factor increased the risk of stroke by 70%. Additionally, the risk factors related to women increased the risk of stroke by 70%. This was independent of non-traditional and traditional risk factors. Each traditional risk factor increased stroke risk by 18% among those with PFOs. Yet, after considering factors such as an individual’s sex, age, and education level, nontraditional factors more than doubled ischemic stroke risk.
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Analyzing The Population Attributable Risk
The researchers also tried to determine how a disease would be affected if a specific risk factor were eliminated. They individually examined every risk factor and its contribution to the increased risk to calculate the population-attributable risk. They found that traditional risk factors accounted for around 65% of the cases where strokes occurred without a PFO. Additionally, they found that 27% could be attributed to nontraditional risks, and 19% of the cases were female-specific risk factors. For strokes associated with PFOs, 34% of the cases were attributed to traditional risk factors. Furthermore, 49% were due to nontraditional risk factors, and 22% were from factors specific to women. Migraines with auras were the leading nontraditional risk factor linked to strokes of unknown origin.
Surprising Results
According to Jukka Putaala, the study’s lead author, “We were surprised by the role of non-traditional risk factors, especially migraine headaches, which seems to be one of the leading risk factors in the development of strokes in younger adults”. He hopes that these results will prompt the medical community to tailor their approach when it comes to risk factor assessment. As Putaala stated, “We should be asking young women if they have a history of migraine headaches and about other nontraditional risk factors.” What makes this study particularly helpful is that the authors present the data by age and sex group. This has helped reveal the prevalence of stroke in young women. However, men tend to have a higher risk during middle age.
Recognizing Specific Risks Associated With Stroke In Young Women
It is very important that we identify the significant contributors to stroke risk in younger women. Therefore, we need to recognize the particular risk factors that affect them as well as those not typically observed, such as pregnancy complications and migraines with auras. Doing so could help change the current approach to screening patients for these risks and consistently educating these individuals about them. The study was not without its limitations, though. For one, it was an observational study based on an analysis of existing data taken from other trials or databases. This means that their findings cannot prove cause and effect. The study also relied on self-reported patient risk factors, which could also potentially affect the accuracy of their findings. Furthermore, because 95% of the participants were white adults, it’s difficult to know if these findings would also apply to other populations.
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