[Skip to Content]
[Skip to Content Landing]
Article
July 1996

Traditional Risk Factors and Ischemic Stroke in Young Adults: The Baltimore-Washington Cooperative Young Stroke Study

Author Affiliations

From the Department of Neurology (Mss Rohr, Feeser, and Whyte, and Drs Kittner, Macko, Price, Sloan, and Wozniak) and the Department of Epidemiology and Preventive Medicine (Drs Kittner, Hebel, Price, Sloan, and Sherwin), University of Maryland Medical School, the Maryland State Department of Health and Mental Hygiene (Ms Weinstein and Dr Kanarak), the Department of Neurology (Drs Buchholz, Earley, Johnson, and Wityk), The Johns Hopkins Hospital, the Department of Neurology (Drs Earley and Johnson), The Johns Hopkins Bayview Medical Center, and the Division of Neurology (Drs Stern and Wityk), Sinai Hospital, Baltimore. Dr Stern is now at the Department of Neurology, Emory University, Atlanta, Ga.

Arch Neurol. 1996;53(7):603-607. doi:10.1001/archneur.1996.00550070041010
Abstract

Objective:  To determine the association of hypertension, diabetes, and cigarette smoking with incidence of ischemic stroke in young adults.

Design:  Case-control study.

Setting:  Population-based sample of cases and controls.

Subjects:  The study included 296 cases of incident ischemic stroke among black and white adults aged 18 to 44 years in central Maryland counties from the Baltimore-Washington Cooperative Young Stroke Study and 1220 black and white adults aged 18 to 44 years from the Maryland Behavioral Risk Factor Survey, a telephone survey of a random sample of the same region, to serve as controls.

Main Outcome Measures:  Logistic regression models were developed to determine the age-adjusted odds ratios for each risk factor. Population-attributable risk percents were computed based on the odds ratios and prevalence of each risk factor.

Results:  The age-adjusted odds ratios (95% confidence intervals) for white men (WM), white women (WW), black men (BM), and black women (BW) were as follows: current cigarette smoking: WM, 2.0 (1.1-3.8), WW, 2.1 (1.1-4.3), BM, 3.3 (1.6-6.6), and BW, 2.2 (1.3-3.9); history of diabetes mellitus: WM, 22.9 (5.8-89.6), WW, 6.2 (1.9-20.2), BM, 4.2 (0.8-21.9), and BW, 3.3 (1.4-7.7); and history of hypertension: WM, 1.6 (0.7-3.2), WW, 2.5 (1.1-5.9), BM, 3.8 (1.8-7.9), and BW, 4.2 (2.4-7.5). The population-attributable risk percents (95% confidence intervals) were as follows: current cigarette smoking: WM, 22.6 (3.1-38.2), WW, 17.2 (4.0-34.0), BM, 40.5 (23.1-54.0), and BW, 29.1 (13.5-41.9); history of diabetes mellitus: WM, 19.0 (8.2-28.5), WW, 15.8 (3.8-26.3), BM, 13.2 (5.3-20.4), and BW, 22.1 (12.5-30.7); and history of hypertension: WM, 21.7 (6.2-34.6), WW, 21.3 (5.4-34.5), BM, 53.5 (39.0-64.4), and BW, 50.5 (37.1-61.1).

Conclusions:  Hypertension, diabetes mellitus, and current cigarette smoking are important risk factors in a biracial young adult population. Cigarette smoking and hypertension, the 2 most modifiable risk factors, were particularly important risk factors in young blacks.

×