Abstract Details

Title Young African Americans With Stroke Have A Greater Burden Of Multiple Risk Factors Than Their White Counterparts

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-021

Objective -

Background Stroke in young adults accounts for 15-18% of all ischemic stroke (IS) and disproportionately affects African Americans (AfrAm). While it is well known that a higher prevalence of risk factors, particularly HTN and DM, contributes to this excess risk, few studies have examined the contribution of synergistic risk from multiple vascular risk factors.

Design/Methods A population-based case-control study with 582 cases and 727 controls ages 15-49 was used to investigate the relationship of risk factors and IS in young adults and compare AfrAM and Whites for the prevalence of multiple risk factors. Logistic regression analysis with adjustment for age, sex, and race was used to evaluate the association between the following risk factor groups and IS: (a) Smoking alone, (b) Smoking+ HTN only, (c) Smoking + HTN +Obesity only (d) Smoking + HTN + Obesity +DM. The reference group was those with no risk factors. Logistic regression with adjustment for age only was also used to compare AfrAM vs White cases for their prevalence in each risk factor group.

Results There were 218 cases with no risk factors. The odds of having an IS increased exponentially as risk factors increased (OR 2.3, 95% CI 1.8 - 3.0, p <0.0001 for group a versus OR 16.5, 95% CI 4.8-56.1, p<0.0001 for group d). Young AfrAM cases were approximately 6 times more likely than White cases to be in the multiple risk factor group d.

Conclusions The risk of IS increases in an exponential manner in young adults with an increasing number of risk factors. Young AfrAm IS cases are 6 times more likely to have all 4 risk factors: smoking, HTN, DM and obesity. Risk factor synergy could contribute to the excess risk of IS among young AfrAm and our study emphasizes the need for early screening for vascular risk factors in this subgroup.

Authors/Disclosures
Prachi Mehndiratta, MD PRESENTER	Dr. Mehndiratta has nothing to disclose.
	No disclosure on file
John Cole, MD (UMD SOM)	Dr. Cole has nothing to disclose.
Marcella A. Wozniak, MD, PhD (U of MD Department of Neurology)	Dr. Wozniak has nothing to disclose.
Seemant Chaturvedi, MD, FAHA, FAAN (University of Maryland)	Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Chaturvedi has received research support from NINDS.
Carolyn Cronin, MD, PhD, FAAN (Vanderbilt University Medical Center)	Dr. Cronin has nothing to disclose.
Michael Phipps, MD, MHS, FAAN (University of Maryland School of Medicine)	Dr. Phipps has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMJ.
Jose G. Merino, MD, MPhil, FAHA, FAAN (MedStar Georgetown University Hospital - Dept of Neurology)	The institution of Dr. Merino has received personal compensation in the range of $100,000-$499,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Merino has received personal compensation in the range of $500-$4,999 for serving as a StrokeNet DSMB Member with National Institute of Neurological Disorders and Stroke.
Tara M. Dutta, MD (Wellspan)	No disclosure on file
Steven J. Kittner, MD, MPH (Dept of Neurology)	The institution of Dr. Kittner has received research support from NINDS.

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