Cabral Norberto Luiz, Freire Aracélli Tavares, Conforto Adriana Bastos, Dos Santos Nayara, Reis Felipe Ibiapina, Nagel Vivian, Guesser Vanessa V, Safanelli Juliana, Longo Alexandre L
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.).
Stroke. 2017 Nov;48(11):2925-2930. doi: 10.1161/STROKEAHA.117.018531. Epub 2017 Oct 6.
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.
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.
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).
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.
在高收入国家，年轻人中风的发病率呈上升趋势。然而，关于低收入和中等收入国家年轻人中风发病率的趋势，我们所知甚少。我们旨在衡量2005年至2015年巴西茹安维尔市年轻人缺血性中风（IS）和脑出血（IH）的发病率趋势。
我们回顾性确定了2005年至2006年、2010年至2011年以及2014年至2015年期间在茹安维尔市发生的所有首次发生的IS亚型和IH病例。采用泊松回归计算所有中风、IS和IH的发病率比值。我们还比较了三个时期危险因素的患病率以及诊断检查的范围。
在10年时间里，我们登记了2483例患者（7.5%年龄小于45岁）。从2005年至2006年到2014年至2015年，45岁以下人群的总体中风发病率显著上升了62%（发病率比值为1.62；95%置信区间为1.10 - 2.40），55岁以下人群上升了29%（发病率比值为1.29；95%置信区间为1.04 - 1.60）。45岁以下人群的IS发病率上升了66%（发病率比值为1.66；95%置信区间为1.09 - 2.54），但IH发病率没有显著变化。吸烟率下降了71%（优势比为0.29；95%置信区间为0.12 - 0.68）。
巴西茹安维尔市年轻人中风发病率上升，原因是缺血性中风而非出血性中风发病率增加。我们迫切需要针对年轻人制定更好的心血管预防政策。
