Department of Neurology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290, Helsinki, Finland.
Stroke. 2012 Oct;43(10):2624-30. doi: 10.1161/STROKEAHA.112.662866. Epub 2012 Jul 12.
We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe.
We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital- or population-based prospective or consecutive young stroke registries involving 15 cities in 12 countries. Geographic regions were defined as northern (Finland, Norway), central (Austria, Belgium, France, Germany, Hungary, The Netherlands, Switzerland), and southern (Greece, Italy, Turkey) Europe. Hierarchical regression models were used for comparisons.
In the study cohort (n=3944), the 3 most frequent risk factors were current smoking (48.7%), dyslipidemia (45.8%), and hypertension (35.9%). Compared with central (n=1868; median age, 43 years) and northern (n=1330; median age, 44 years) European patients, southern Europeans (n=746; median age, 41 years) were younger. No sex difference emerged between the regions, male:female ratio being 0.7 in those aged <34 years and reaching 1.7 in those aged 45 to 49 years. After accounting for confounders, no risk-factor differences emerged at the region level. Compared with females, males were older and they more frequently had dyslipidemia or coronary heart disease, or were smokers, irrespective of region. In both sexes, prevalence of family history of stroke, dyslipidemia, smoking, hypertension, diabetes mellitus, coronary heart disease, peripheral arterial disease, and atrial fibrillation positively correlated with age across all regions.
Primary preventive strategies for ischemic stroke in young adults-having high rate of modifiable risk factors-should be targeted according to sex and age at continental level.
我们比较了欧洲三个不同地理区域的年轻缺血性脑卒中患者中，性别和年龄组之间血管危险因素的分布情况。
我们纳入了年龄在 15 至 49 岁的首次缺血性脑卒中患者，这些患者来自 12 个国家 15 个城市的现有医院或人群为基础的前瞻性或连续的青年脑卒中登记处。地理区域被定义为北欧（芬兰、挪威）、中欧（奥地利、比利时、法国、德国、匈牙利、荷兰、瑞士）和南欧（希腊、意大利、土耳其）。我们使用分层回归模型进行比较。
在研究队列（n=3944）中，最常见的三个危险因素是当前吸烟（48.7%）、血脂异常（45.8%）和高血压（35.9%）。与中欧（n=1868；中位年龄 43 岁）和北欧（n=1330；中位年龄 44 岁）的欧洲患者相比，南欧患者（n=746；中位年龄 41 岁）更年轻。各区域之间没有出现性别差异，年龄<34 岁的患者中男女比例为 0.7，年龄 45 至 49 岁的患者中男女比例为 1.7。在调整混杂因素后，各区域之间不存在危险因素差异。与女性相比，男性年龄较大，更常患有血脂异常或冠心病，或为吸烟者，无论其所在区域如何。在男女两性中，无论所在区域如何，家族史、血脂异常、吸烟、高血压、糖尿病、冠心病、外周动脉疾病和房颤的患病率均与年龄呈正相关。
在大陆层面上，针对年轻成年人的缺血性脑卒中一级预防策略，应该根据性别和年龄来制定。
