Men's Stroke Risk Rises Dramatically in Mid-40s
And the contributing factors are often
those seen in older patients, study finds
By Amanda Gardner
HealthDay Reporter
THURSDAY,
Feb. 26 (HealthDay News) -- The odds of having a
stroke seem to spike up when men reach their mid-40s.
And
the risks associated with stroke even at this earlier age are startlingly
similar to the risk factors seen in older patients, a new study found.
"Silent strokes" -- which have
no obvious symptoms but can cause residual
damage -- are also common in this younger group of men, researchers reported
Feb. 26 in the journal Stroke.
"The
risk factors are most of the ones we start thinking about in older people --
mostly cholesterol, but also smoking, high blood pressure and
diabetes. So that's something we need to start looking at, at a younger
age," said Dr. Michael Palm, assistant professor of neuroscience
and experimental therapeutics and
internal medicine at the
"If
we wait till 50, many of these risk factors are already fairly well established
and causing problems," he said.
Since
many of these risk factors are modifiable, "there is a need for developing
aggressive primary prevention strategies," added Dr. Jukka
Putaala, lead author of the new study. "The
optimal target group for primary prevention interventions [especially among
men] could perhaps be 35 to 44 years."
The
phenomenon of silent strokes in younger men also needs to be explored, Putaala said, because such "subclinical" strokes
are associated with a high risk of later strokes as well as cognitive decline
in older people.
Putaala and colleagues at Helsinki University Central Hospital in
Finland evaluated more than 1,000 patients aged 15 to 49 who had been admitted
to the hospital between 1994 and 2007 with an ischemic stroke, which is caused
by a blocked blood vessel.
As
expected, the occurrence of stroke increased dramatically with age. Females
were more likely to have a stroke among people under the age of 30, while males
predominated starting at about age 44.
Sixty
percent of stroke patients had high cholesterol, 44 percent smoked and 39
percent had hypertension, the researchers found.
"It
was commonly understood that people who have strokes when they're young have a
different set of causes than people when they're older," said Dr. Roger Bonomo, director of stroke care at
But,
Bonomo cautioned, the new study was done with a
specific population in
A
second study in the same issue of the journal found that feeling sleepy during
the day appears to increase the risk of dying from cardiovascular disease among
healthy older people.
Some
10 percent to 30 percent of older adults report having daytime
sleepiness, according to the French researchers who did the study.
Among
a group of more than 9,000 people aged 65 or over, excessive daytime sleepiness
(EDS) was linked with a 33 percent increased risk of dying. Both loud snorers
and non-snorers with EDS had an increased risk in mortality. There was no link
between excessive daytime sleepiness and dying of cancer.
"This
is important, because I think the general physician doesn't always take [EDS]
into account," said Dr. John Erwin III, associate professor of internal
medicine at Texas A&M Health Science Center
College of Medicine and a senior staff cardiologist with Scott & White
Hospital in Temple.
"We're
taught in medical school that the need for sleep becomes less as people age.
The science over the last few years is pointing us away from that, and we see
quite a few patients in clinic that complain of this. This probably underscores
the need to be more aggressive in referring patients to sleep clinics," he
said.
The
possibility that sleepiness is an indication of depression also needs to be
explored, Erwin said, because depression is associated with a higher risk for
heart disease.