Risk Of Stroke By Age

Introduction to Stroke Risk Factors by Age

Stroke is a multifactorial disease that can affect individuals at any age, but the risk factors and their impact can vary significantly depending on the age group. Understanding these variations is crucial for developing effective prevention strategies tailored to different age demographics.

Stroke Risk in Younger Adults (18-45 Years)

In individuals younger than 45 years, conventional vascular risk factors such as hypertension, smoking, binge drinking, central obesity, cardiac causes, dyslipidemia, and psychosocial stress are significant contributors to stroke risk. Hypertension, in particular, stands out as the most critical risk factor across all age groups and stroke subtypes. The INTERSTROKE study highlighted that cardiac causes and binge drinking of alcohol are particularly potent risk factors in this age group, with odds ratios (OR) of 8.42 and 5.44, respectively.

Stroke Risk in Middle-Aged Adults (45-64 Years)

For middle-aged adults, the risk of stroke remains substantial. The Framingham Study reported that the lifetime risk (LTR) of stroke for individuals at age 55 is approximately 1 in 6 for men and 1 in 5 for women, with hypertension being a significant determinant. Additionally, a predictive risk stratification tool developed for the Chinese population aged 45 and above identified low physical performance and the triglyceride-glucose index as key predictors of new-onset stroke within seven years.

Stroke Risk in Older Adults (65-74 Years)

In the age group of 65-74 years, heart failure and elevated high-density lipoprotein (HDL) levels are associated with worsening neurological function in acute ischemic stroke (AIS) patients. Conversely, obesity appears to be linked with improved neurological outcomes in this age group. The REGARDS cohort study also found that the association of diabetes and heart disease with stroke risk diminishes with age, while the impact of smoking, atrial fibrillation, and left ventricular hypertrophy remains consistent.

Stroke Risk in the Elderly (75 Years and Above)

For individuals aged 75 and above, the risk factors for stroke shift slightly. Hypertension and atrial fibrillation become more prevalent, while the influence of diabetes and hyperlipidemia decreases. The Burgos University Hospital study found that high blood pressure (HBP) is significantly associated with a higher likelihood of stroke in individuals over 75 years. Additionally, direct hospital admission is linked with improved neurological functions in this age group.

Global and Regional Variations in Lifetime Stroke Risk

Globally, the lifetime risk of stroke from the age of 25 years onward is approximately 25% for both men and women. However, there are significant geographic variations. The highest risks are observed in East Asia, Central Europe, and Eastern Europe, while the lowest risks are found in eastern sub-Saharan Africa. These variations highlight the importance of considering regional factors when assessing stroke risk.

Conclusion

The risk of stroke varies significantly with age, influenced by different risk factors at each stage of life. Younger adults are more affected by lifestyle-related factors such as smoking and alcohol consumption, while older adults face increased risks from hypertension and atrial fibrillation. Understanding these age-related differences is essential for developing targeted prevention strategies and improving stroke outcomes across all age groups.

Risk of stroke by age

Summary

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