Norman Kristina, Eriksson Marie, von Euler Mia
School of Medicine, Örebro University, Örebro, Sweden.
Department of Statistics, USBE, Umeå University, Umeå, Sweden.
Front Neurol. 2022 Feb 14;13:793181. doi: 10.3389/fneur.2022.793181. eCollection 2022.
Stroke incidence is decreasing in most developing countries. However, worrisome trends of an increase in the younger population have been described.
To investigate sex differences and longitudinal changes in ischemic stroke regarding incidence, cardiovascular risk factors, and outcome, in the young.
This is an observational study based on the data from the Swedish national stroke registry, Riksstroke. Patients, 18-54 years of age, having ischemic stroke between 2005 and 2018 were included, resulting in a study population of 16,210 patients.
The incidence was higher in men than in women (30.6 vs. 19.1 per 100,000, < 0.001). After an initial increase, the incidence stabilized and then decreased, resulting in a similar level in 2018 as in 2005. Atrial fibrillation, diabetes, and usage of anti-hypertensives at stroke onset were more common among men and did not change over time. Smoking was common and slightly more so in women, but with a reduced prevalence in both men and women during the study period. Dependency in Activities of Daily Living (ADL) and case fatality showed no clear trends or sex differences.
The results show that there are sex differences in ischemic stroke in the younger age group regarding incidence and vascular risk factors, particularly smoking. Temporal trends in stroke incidence are difficult to interpret as fluctuations are substantial, largely due to stroke being quite uncommon in the younger population.
在大多数发展中国家，中风发病率正在下降。然而，已有研究描述了年轻人群中令人担忧的上升趋势。
调查年轻人缺血性中风在发病率、心血管危险因素和预后方面的性别差异及纵向变化。
这是一项基于瑞典国家中风登记处（Riksstroke）数据的观察性研究。纳入2005年至2018年间年龄在18 - 54岁之间的缺血性中风患者，最终研究人群为16210例患者。
男性发病率高于女性（每10万人中分别为30.6例和19.1例，<0.001）。在最初上升后，发病率稳定下来然后下降，2018年的发病率水平与2005年相似。房颤、糖尿病以及中风发作时使用抗高血压药物在男性中更为常见，且随时间无变化。吸烟很常见，女性略多，但在研究期间男性和女性的吸烟率均有所下降。日常生活活动（ADL）依赖和病死率无明显趋势或性别差异。
结果表明，在年轻年龄组的缺血性中风中，发病率和血管危险因素，尤其是吸烟方面存在性别差异。中风发病率的时间趋势难以解释，因为波动很大，这主要是由于中风在年轻人群中相当不常见。
