title: Early vascular aging in young and middle-aged ischemic stroke patients: the Norwegian Stroke in the Young Study.
abstract: BACKGROUND
  Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.
  
  
  METHODS
  We measured aortic stiffness by carotid-femoral pulse wave velocity (PWV) in 205 patients (69% men) aged 15-60 years with acute ischemic stroke in the prospective Norwegian Stroke in the Young Study. High for age carotid-femoral PWV was identified in the reference normogram.
  
  
  RESULTS
  Patients were on average 49 ± 10 years old, 34% had a history of hypertension and 37% had metabolic syndrome (MetS). In the total study population, higher PWV was associated with history of hypertension (β = 0.18), higher age (β = 0.34), systolic blood pressure (BP) (β = 0.28) and serum creatinine (β = 0.18) and lower high-density lipoprotein (HDL) cholesterol (β = -0.10, all p < 0.01) in multivariate linear regression analysis (multiple R2 = 0.42, p < 0.001). High for age PWV was found in 18% of patients. In univariate analyses, known hypertension was associated with a 6-fold, MetS with a 4-fold and presence of carotid plaque with a 3.7-fold higher risk for high for age PWV (all p < 0.01). In multiple logistic regression analysis higher systolic BP (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.02-1.06; p < 0.01), history of hypertension (OR 3.59; 95% CI 1.52-8.51; p < 0.01), low HDL cholesterol (OR 3.03; 95% CI 1.00-9.09; p = 0.05) and higher serum creatinine (OR 1.04; 95% CI 1.01-1.06; p < 0.01) were associated with high for age PWV.
  
  
  CONCLUSIONS
  Higher PWV is common in younger and middle-aged ischemic stroke patients and associated with a clustering of classical cardiovascular risk factors. ClinicalTrials.gov NCT01597453.
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Sahrai
authors.initials: S
authors.lastname: Saeed
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Waje-Andreassen
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: Annette
authors.initials: A
authors.lastname: Fromm
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: Halvor
authors.initials: H
authors.lastname: Øygarden
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
authors.forename: Marina V
authors.initials: MV
authors.lastname: Kokorina
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Halvor
authors.initials: H
authors.lastname: Naess
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016014:Linear Models; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D003404:Creatinine