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June 2017

Are More Young People Having Strokes?—A Simple Question With an Uncertain Answer

Author Affiliations
  • 1Department of Neurology, University of Michigan, Ann Arbor
  • 2Ann Arbor VA Department of Neurology, Ann Arbor, Michigan
JAMA Neurol. 2017;74(6):639-641. doi:10.1001/jamaneurol.2017.0161

If a headline such as “Stroke Tsunami: 30 000 More Strokes in the Young” pops into your Twitter feed based on a study in this month’s issue of JAMA Neurology, should the claim be taken seriously? Is urgent action needed to reverse this trend? While that headline would certainly be eye-catching, the best short answer makes for a lede begging to be buried, “Maybe, but the evidence is pretty cloudy.”

Using data from the Nationwide Inpatient Sample—a large and nationally representative administrative database of hospital discharge abstracts—George et al1 found that ischemic stroke hospitalizations are increasing in adults younger than age 65 years in the United States, with almost 30 000 more stroke hospitalizations in 2012 than in 2003, a relative increase in hospitalization rates by 20% to 40%. Similarly, they found across-the-board increases in vascular risk factor diagnoses in young adults discharged with an ischemic stroke. If these findings represent a true epidemiologic trend, understanding the reasons underlying this trend and seeking to reverse it should be a leading priority of the stroke community. However, it is not yet clear whether such urgent action is needed.

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