Abstract P408: Ischemic Stroke Risk Factor Differences and Their Changes Over Time Among Young (45 Years or Less) Persons in a Rural State: 2012-2017

Kristin Weeks; James C Torner

doi:10.1161/circ.139.suppl_1.P408

Introduction: A positive public health trend in Iowa in the last decade has been the decreasing mortality by stroke. However, there has been an alarming trend in the increased occurrence of stroke in the younger population (≤45 years) in Iowa from 2010-2018. The risk factors responsible for the rising incidence in the young need attention for prevention. Hypothesis: This analysis examines whether over time young persons with stroke will have a different frequency and distribution of some cardiovascular risk factors at the time of their stroke. Additionally, we analyze if the risk factor prevalence varies by age cohort and if risk factor prevalence differs from the general age-matched population in Iowa. Methods: Using the Iowa Stroke Registry, data from 22,652 patients from 2012-2017 was collected from 32 hospitals. We investigated demographics, medical, social, and family histories by age (≤45, >45) across time (2012-2017) for ischemic strokes. Statistical analysis was done to determine if for each age cohort a factor varied significantly over time, and if factor prevalence varied between age groups. Comparisons were using Chi-Square tests for categorical variables and ANOVA for continuous variables with an alpha=0.05. Trend of change over time was analyzed. We used Iowa Behavioral Risk Factor Surveillance System data from 2015 to compare prevalence of risk factors among stroke patients and the population. Results: Compared to over 45 years old stroke patients, 45 or less years old stroke patients in Iowa in 2012-2018 have a higher prevelance at the time of their stroke of obesity, morbid obesity, drug abuse, migraines, a family history of stroke and a smoking history (p=<0.05). There was a lower prevalance of past cardiovascular event, dyslipidemia, hypertension, atrial fibulation, antiplatelet medication use, anticoagulant medication use, and antihypertension medication use (p=<0.05). Dyslipidemia and hypertension decreased in prevelance among stroke patients over years (R 2 0.45, 0.44). Also in comparison to their age-matched Iowa counterparts, Iowa stroke patients have a higher prevelance of smoking, diabetes, prior stroke, prior MI, hypertension, high cholesterol. They have lower diagnosed depression and no difference in obesity. Conclusions: Younger persons with strokes experience risk factors at different proportions than older patients with strokes and the prevalence of these risk factors are changing over time. The ≤45 year old stroke patients vary from their overall age-matches state counterparts in their risk factor prevalence. Overall, these findings highlight the need for increased screening and preventive interventions by public health and health care providers.

Abstract P408: Ischemic Stroke Risk Factor Differences and Their Changes Over Time Among Young (45 Years or Less) Persons in a Rural State: 2012-2017

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