Abstract
BackgroundStroke incidence is decreasing in most developing countries. However, worrisome trends of an increase in the younger population have been described.AimTo investigate sex differences and longitudinal changes in ischemic stroke regarding incidence, cardiovascular risk factors, and outcome, in the young.MethodsThis is an observational study based on the data from the Swedish national stroke registry, Riksstroke. Patients, 18–54 years of age, having ischemic stroke between 2005 and 2018 were included, resulting in a study population of 16,210 patients.ResultsThe incidence was higher in men than in women (30.6 vs. 19.1 per 100,000, P < 0.001). After an initial increase, the incidence stabilized and then decreased, resulting in a similar level in 2018 as in 2005. Atrial fibrillation, diabetes, and usage of anti-hypertensives at stroke onset were more common among men and did not change over time. Smoking was common and slightly more so in women, but with a reduced prevalence in both men and women during the study period. Dependency in Activities of Daily Living (ADL) and case fatality showed no clear trends or sex differences.ConclusionsThe results show that there are sex differences in ischemic stroke in the younger age group regarding incidence and vascular risk factors, particularly smoking. Temporal trends in stroke incidence are difficult to interpret as fluctuations are substantial, largely due to stroke being quite uncommon in the younger population.
Highlights
Age and sex are important non-modifiable risk factors for stroke
We aimed to investigate sex differences in ischemic stroke regarding incidence, risk factors, and case fatality in the younger populations
The registry’s coverage of stroke incidence is high, calculated to 89% when compared to the patient registry (PAR) [8]
Summary
Age and sex are important non-modifiable risk factors for stroke. The absolute number of strokes is lower for women before the age of 75 years but more than twice as high as in men after the age of 75 [2]. The incidence is higher among men than women below the age of 60. In a study of 411 patients between 18 and 50 years of age from China, 67% were male and 88% of the male patients had at least one risk factor, compared to 54% of the women [4]. Some of the risk factors observed more often in men were hypertension, diabetes mellitus, and smoking [4]. Stroke incidence is decreasing in most developing countries. Worrisome trends of an increase in the younger population have been described
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