---
title: "Neurologisk JC"
subtitle: "Temporal Trends in Vascular Risk Factor Burden Among Young Adults With Ischemic Stroke"
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## Background
- Stroke is a leading cause of death and disability  
- Traditionally considered a disease of older adults  
- Rising stroke incidence among **young adults (18–55 years old)**  
- Increasing **vascular risk factors (VRFs)** may be driving this trend  
- Study aims to analyze **temporal trends in VRF burden** among young stroke patients  


## Study Design & Data Source
- **Prospective Cohort Study** using **Florida Stroke Registry (FSR)**  
- Data collected from **2014–2022** across **172 hospitals**  
- **Inclusion Criteria:**  
  - Patients **18–55 years old** with **ischemic stroke (IS)**  
- **Exclusion Criteria:**  
  - Patients outside age range  
  - Patients with **TIA, intracranial hemorrhage, or subarachnoid hemorrhage**  


## Data Collection & Variables
- Data obtained from **Get With The Guidelines-Stroke (GWTG-S)**  
- **Demographics:**  
  - Age, sex, race/ethnicity  
- **Vascular Risk Factors (VRFs):**  
  - Hypertension, dyslipidemia, obesity, diabetes, smoking  
  - Atrial fibrillation, coronary artery disease, heart failure, sleep apnea  
- **Polymorbidity:** Defined as **3 or more VRFs**  


## Statistical Analysis
- **Comparative Analysis:**  
  - Continuous variables: **t-test / Wilcoxon-Mann-Whitney**  
  - Categorical variables: **Chi-square test**  
- **Temporal Trends Analysis:**  
  - VRF trends assessed across study period  


## Main Results
- **Total patients analyzed:** 36,488  
- **Age breakdown:**
  - 18–35 years: **3,363 patients (9.2%)**  
  - 36–55 years: **33,125 patients (90.8%)**  
  
##
- **Key Findings:**
  - **Polymorbidity (≥3 VRFs) increased** over time:  
    - **18–35 years:** 10.9% → 16.4% (p = 0.002)  
    - **36–55 years:** 34.6% → 41.9% (p < 0.001)  
  - **Higher VRF burden in**:
    - **Non-Hispanic Black** patients
    - **Male** patients  
  - **Most common VRFs:** Hypertension, obesity, diabetes  


## Strengths of the Study
✅ **Large, diverse cohort** from a statewide registry  
✅ **Standardized data collection** via GWTG-S  
✅ **Analyzed temporal trends** in VRFs  
✅ **Examined racial & sex disparities** in VRF burden  



## Study Limitations
❌ **Limited generalizability** (Florida hospitals only)  
❌ **No stroke etiology data** (high missingness)  
❌ **Unknown VRF severity & management** (no treatment data)  
❌ **Potential bias in VRF reporting** (better diagnosis over time)  
❌ **Lack of socioeconomic data** (income, education, access to care)  



## Conclusion
- **VRF burden is increasing** in young adults with stroke  
- **Disparities exist**—higher polymorbidity in **Black and male patients**  
- **Early identification & prevention strategies** are crucial  
- **Future research** should focus on **stroke etiology & socioeconomic factors**