Abstract MP51: 24-Year Risk of Stroke in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Background: Although stroke incidence rate has been increasing in young adults and is high in African Americans (AA), little is known about the etiology underlying this trend. We examined incidence and risk factors for stroke in 5,115 AA and white (W) men and women aged 18-30 years at year 0 (1985-86) of the CARDIA study.
Methods: Participants were surveyed annually regarding hospitalization for stroke. Medical and mortality records were adjudicated by study physicians according to the study protocol. Follow-up time was year 0 date to the earliest of: last contact date in the CARDIA study, date of stroke, date of death, or end of year 24 follow-up (last possible date 8/31/2010). We used cumulative incidence rates and Cox proportional hazards models, predicting from year 0 values of age, race, gender, and one of systolic blood pressure (BP), diastolic BP, dichotomous BP (BP > 120/80 vs. <120/80 mm Hg or on BP medication); and smoking, alcohol use, total cholesterol, physical activity score, body mass index, and one of fasting glucose (FBG) or dichotomous FBG (>100 vs. <100 mg/dl).
Results: There were 39 incident strokes (29 AA, 10 W) representing 1.1% of AA and 0.4% of W during follow-up (mean 23.3 years). The incidence rate was 3.3 per 10,000 person-years and mean age for stroke was 42.9 years. AA had approximately 3 times the risk of stroke as W. Both diastolic BP and FBG were associated with stroke risk (see Table), while systolic BP was not. In models including diastolic BP and FBG, a 10 unit increase in diastolic BP and in FBS increased stroke risk by 50% and 12% respectively. BP >120/80 mm Hg or on BP medication and FBG >100 mg/dl were associated with hazard ratios of 2.66 and 4.12 respectively.
Conclusions: The risk of stroke in relatively young adults was 3 times higher in blacks than whites and was associated with higher diastolic BP and blood glucose during their late teens and twenties. This finding adds evidence to the concern that higher levels of blood pressure in young adult AAs may lead to earlier occurrence of clinical cardiovascular disease.
- © 2013 by American Heart Association, Inc.