Familial aggregation of ischemic stroke in young women: the Stroke Prevention in Young Women Study.
OBJECTIVE
Stroke occurs infrequently in young adults. While a familial basis for older onset stroke is well established, the extent of familial clustering in young-onset stroke is unknown. To address this issue, we compared the frequency of stroke in relatives of stroke cases to that in relatives of controls across different ages and by stroke subtype.


METHODS
Through a population-based case-control study of stroke, we identified 487 women aged 15-49 years with ischemic stroke and 615 women without stroke matched by age and geographic region. Family history of stroke was collected for 5,749 relatives (parents and siblings) of case and control probands by standardized interview.


RESULTS
Strokes were reported in 149 relatives of case patients and 119 relatives of controls. Siblings of stroke case patients had more than four times the risk of stroke compared to siblings of controls (OR, 4.17; 95% CI, 1.9-8.8) and mothers of stroke case patients had twice the risk of stroke compared to mothers of control subjects (OR, 2.02; 95% CI, 1.4-3.0). The association between stroke in probands and family history of stroke was strongest among women aged 15-24 years (OR, 2.5; 95% CI, 0.4-15.1), and diminished with increasing proband age (OR, 1.6; 95% CI, 0.8-3.3 among women 25-34 years and OR, 1.5; 95% CI, 1.1-1.9 among women 35-49 years; P<0.0001 for trend).


CONCLUSIONS
We conclude that young-onset stroke aggregates in families and that the magnitude of aggregation increases with decreasing proband age.
MacClellan
Leah R
LR
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA. lmacclel@epi.umaryland.edu
Mitchell
Braxton D
BD
Cole
John W
JW
Wozniak
Marcella A
MA
Stern
Barney J
BJ
Giles
Wayne H
WH
Brown
David W
DW
Sparks
Mary J
MJ
Kittner
Steven J
SJ
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002544:Cerebral Infarction / Q000453:epidemiology* / Q000517:prevention & control; D016000:Cluster Analysis; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D012307:Risk Factors