Traditional risk factors and ischemic stroke in young adults: the Baltimore-Washington Cooperative Young Stroke Study.
OBJECTIVE
To determine the association of hypertension, diabetes, and cigarette smoking with incidence of ischemic stroke in young adults.


METHODS
Case-control study.


METHODS
Population-based sample of cases and controls.


METHODS
The study included 296 cases of incident ischemic stroke among black and white adults aged 18 to 44 years in central Maryland counties from the Baltimore-Washington Cooperative Young Stroke Study and 1220 black and white adults aged 18 to 44 years from the Maryland Behavioral Risk Factor Survey, a telephone survey of a random sample of the same region, to serve as controls.


METHODS
Logistic regression models were developed to determine the age-adjusted odds ratios for each risk factor. Population-attributable risk percent were computed based on the odds ratios and prevalence of each risk factor.


RESULTS
The age-adjusted odds ratios (95% confidence intervals) for white men (WM), white women (WW), black men (BM), and black women (BW) were as follows: current cigarette smoking: WM, 2.0 (1.1-3.8), WW, 2.1 (1.1-4.3), BM, 3.3 (1.6-6.6), and BW, 2.2 (1.3-3.9); history of diabetes mellitus: WM, 22.9 (5.8-89.6), WW, 6.2 (1.9-20.2), BM, 4.2 (0.8-21.9), and BW, 3.3 (1.4-7.7); and history of hypertension: WM, 1.6 (0.7-3.2), WW, 2.5 (1.1-5.9), BM, 3.8 (1.8-7.9), and BW, 4.2 (2.4-7.5). The population-attributable risk percent (95% confidence intervals) were as follows: current cigarette smoking: WM, 22.6 (3.1-38.2), WW, 17.2 (4.0-34.0), BM, 40.5 (23.1-54.0), and BW, 29.1 (13.5-41.9); history of diabetes mellitus: WM, 19.0 (8.2-28.5), WW, 15.8 (3.8-26.3), BM, 13.2 (5.3-20.4), and BW, 22.1 (12.5-30.7); and history of hypertension: WM, 21.7 (6.2-34.6), WW, 21.3 (5.4-34.5), BM, 53.5 (39.0-64.4), and BW, 50.5 (37.1-61.1).


CONCLUSIONS
Hypertension, diabetes mellitus, and current cigarette smoking are important risk factors in a biracial young adult population. Cigarette smoking and hypertension, the 2 most modifiable risk factors, were particularly important risk factors in young blacks.
Rohr
J
J
Department of Neurology, University of Maryland Medical School, Baltimore 21201-1559, USA.
Kittner
S
S
Feeser
B
B
Hebel
J R
JR
Whyte
M G
MG
Weinstein
A
A
Kanarak
N
N
Buchholz
D
D
Earley
C
C
Johnson
C
C
Macko
R
R
Price
T
T
Sloan
M
M
Stern
B
B
Wityk
R
R
Wozniak
M
M
Sherwin
R
R
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D044383:Black People; D002545:Brain Ischemia / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D016022:Case-Control Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000208:ethnology; D008297:Male; D008396:Maryland / Q000453:epidemiology; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D044465:White People