Severe extracranial carotid atherosclerosis in young adults.

Studies of stroke in adults under age 50 emphasize nonatherosclerotic causes. We examined the risk factor profile in 41 patients under age 45 who underwent carotid endarterectomy for severe atherosclerotic stenosis at the Cleveland Clinic Foundation from 1975 to 1990. Smoking was the strongest risk factor. Hyperlipidemia, family history, and associated coronary atherosclerosis were also major risk factors. In contradistinction to older patients with carotid disease, hypertension was a less important risk factor.