Abstract MP02: Association Of Socioeconomic Status With Stroke In Non-elderly Adults

Abstract

Background: Stroke is increasing among the non-elderly adults (<65 years of age) in the United States (US). We investigated the combined effects of socioeconomic status (SES), race/ethnicity, and traditional risk factors on stroke in this population. Methods: Using the National Health Interview Survey (NHIS) database from 2012 to 2018, we examined the association of traditional risk factors (hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity), sociodemographic, cardiovascular risk factor (CRF) profile (CRF range: Optimal (0-1 cardiovascular risk factors) to Poor (≥ 4 cardiovascular risk factors)), family income (high to low based on income as percentage of poverty limit), and educational attainment (categorized as some college degree or higher vs high school (HS) degree/GED or less) with stroke in the young (18-44 years) and middle-aged (45-64 years) adults. Results: Among 168,862 non-elderly adults (55% in young adults) included in this study, the prevalence of stroke was 1.83% among the non-elderly which translates to roughly 3.1 million adults. Of these, 598 and 2,509 were young- and middle-aged adults, translating to 624,000 and 2.5 million US adults, respectively. Adults with low family income, lesser education, and who were black were more likely to have stroke. The majority of young adults without stroke had an optimal CRF profile (65%) with only 3.5% having a poor profile. In contrast, 17.7% of middle-aged adults had a poor CRF profile. Lower income status coupled with a poor CRF profile increased the odds of stroke in both young (adjusted [a]OR: 3.12 [2.12-4.59]) and middle-aged (aOR: 2.31 [1.97-2.72]) adults when compared to those with average or optimal CRF profiles. Conclusions: This national survey of non-elderly US adults showed that poor CRF profiles led to higher odds of stroke compared to optimal profiles. Additionally, low income and education, factors contributing to SES, and race/ethnicity contributed to worsening stroke odds.