Norberto Luiz Cabral1, Aracélli Tavares Freire2, Adriana Bastos Conforto2, Nayara Dos Santos2, Felipe Ibiapina Reis2, Vivian Nagel2, Vanessa V Guesser2, Juliana Safanelli2, Alexandre L Longo2. 1. From the Joinville Stroke Registry, Brazil (N.L.C., J.S., V.N., V.V.G.); University of Joinville Region, Brazil (N.L.C., J.S., A.T.F., F.I.R.); Division of Clinical Neurology, Faculdade de Medicina, Hospital das Clinicas da Universidade de São Paulo, Brazil (A.B.C.); Hospital Israelita Albert Einstein, São Paulo, Brazil (A.B.C.); and Hospital Municipal São Jose, Joinville, Brazil (N.d.S., A.L.L.). norbertocabral@icloud.com. 2. From the Joinville Stroke Registry, Brazil (N.L.C., J.S., V.N., V.V.G.); University of Joinville Region, Brazil (N.L.C., J.S., A.T.F., F.I.R.); Division of Clinical Neurology, Faculdade de Medicina, Hospital das Clinicas da Universidade de São Paulo, Brazil (A.B.C.); Hospital Israelita Albert Einstein, São Paulo, Brazil (A.B.C.); and Hospital Municipal São Jose, Joinville, Brazil (N.d.S., A.L.L.).
Abstract
BACKGROUND AND PURPOSE: The incidence of stroke is on the rise in young adults in high-income countries. However, there is a gap of knowledge about trends in stroke incidence in young adults from low- and middle-income countries. We aimed to measure trends in incidence of ischemic stroke (IS) and intracerebral hemorrhage (IH) in young people from 2005 to 2015 in Joinville, Brazil. METHODS: We retrospectively ascertained all first-ever IS subtypes and IH that occurred in Joinville in the periods of 2005 to 2006, 2010 to 2011, and 2014 to 2015. Poisson regression was used to calculate incidence rate ratios of all strokes, IS, and IH. We also compared the prevalence of risk factors and extension of diagnostic work-up across the 3 periods. RESULTS: For 10 years, we registered 2483 patients (7.5% aged <45 years). From 2005 to 2006 to 2014 to 2015, overall stroke incidence significantly increased by 62% (incidence rate ratios, 1.62; 95% confidence interval, 1.10-2.40) in subjects <45 years and by 29% in those <55 years (incidence rate ratios, 1.29; 95% confidence interval, 1.04-1.60). Incidence of IS increased by 66% (incidence rate ratios, 1.66; 95% confidence interval, 1.09-2.54), but there was no significant change in incidence of IH in subjects <45 years. Smoking rates decreased by 71% (odds ratio, 0.29; 95% confidence interval, 0.12-0.68). CONCLUSIONS: Stroke incidence is rising in young adults in Joinville, Brazil, because of increase in rates of ischemic but not hemorrhagic strokes. We urgently need better policies of cardiovascular prevention in the young.
BACKGROUND AND PURPOSE: The incidence of stroke is on the rise in young adults in high-income countries. However, there is a gap of knowledge about trends in stroke incidence in young adults from low- and middle-income countries. We aimed to measure trends in incidence of ischemic stroke (IS) and intracerebral hemorrhage (IH) in young people from 2005 to 2015 in Joinville, Brazil. METHODS: We retrospectively ascertained all first-ever IS subtypes and IH that occurred in Joinville in the periods of 2005 to 2006, 2010 to 2011, and 2014 to 2015. Poisson regression was used to calculate incidence rate ratios of all strokes, IS, and IH. We also compared the prevalence of risk factors and extension of diagnostic work-up across the 3 periods. RESULTS: For 10 years, we registered 2483 patients (7.5% aged <45 years). From 2005 to 2006 to 2014 to 2015, overall stroke incidence significantly increased by 62% (incidence rate ratios, 1.62; 95% confidence interval, 1.10-2.40) in subjects <45 years and by 29% in those <55 years (incidence rate ratios, 1.29; 95% confidence interval, 1.04-1.60). Incidence of IS increased by 66% (incidence rate ratios, 1.66; 95% confidence interval, 1.09-2.54), but there was no significant change in incidence of IH in subjects <45 years. Smoking rates decreased by 71% (odds ratio, 0.29; 95% confidence interval, 0.12-0.68). CONCLUSIONS:Stroke incidence is rising in young adults in Joinville, Brazil, because of increase in rates of ischemic but not hemorrhagic strokes. We urgently need better policies of cardiovascular prevention in the young.
Authors: Michelle H Leppert; James F Burke; Lynda D Lisabeth; Tracy E Madsen; Dawn O Kleindorfer; Stefan Sillau; Lee H Schwamm; Stacie L Daugherty; Cathy J Bradley; P Michael Ho; Sharon N Poisson Journal: Stroke Date: 2022-01-24 Impact factor: 7.914
Authors: Muhammad K Ahmed; Haris Kamal; Jessica L Weiss; Annemarie Crumlish; Peyman Shirani; Robert N Sawyer; Ashkan Mowla Journal: Brain Circ Date: 2021-05-29
Authors: Henrique de Moraes Bernal; Luiz Carlos de Abreu; Italla Maria Pinheiro Bezerra; Fernando Adami; Jessica Miwa Takasu; João Victor Ji Young Suh; Silmara de Lira Ribeiro; Edige Felipe de Sousa Santos Journal: PLoS One Date: 2020-11-16 Impact factor: 3.240