Study calls for greater awareness and control of vascular risk factors that lead to stroke

Study calls for greater awareness and control of vascular risk factors that lead to stroke

Researchers from the Stroke Research and Prevention Group (HKU Stroke), Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong (HKUMed) found that the incidence of "young stroke" (stroke in people aged 18 to 55 years) increased by 30% in Hong Kong from 2001 to 2021, thus calling for better control of vascular risk factors, particularly hypertension.

Research background and results

Stroke is the second leading cause of death and a leading cause of disability worldwide. Although the overall incidence of stroke has decreased in high-income countries, the incidence of stroke in younger populations has increased worldwide. However, the epidemiology of “young stroke” in Hong Kong remains uncertain.
Using the Clinical Data Analysis and Reporting System of Hospital Authority, the research team analyzed stroke trends in Hong Kong from 2001 to 2021 and found that the crude incidence of young strokes increased sharply from 39.1 per 100,000 people in 2001 to 48.3 per 100,000 in 2011 and 55.7 per 100,000 in 2011 2021 (Figure 1). Although the total number of new stroke cases admitted to hospitals under hospital supervision has remained similar at about 13,500 to 14,000 per year over the past 20 years, the number of young stroke cases increased from 1,531 in 2001 to 2,028 in 2021.

To identify risk factors for stroke in young people, the study also examined a cohort of 431 stroke patients aged 18 to 55 years who were admitted to Queen Mary Hospital and Ruttonjee Hospital in Hong Kong between September 2019 and August 2022. Among them: 53% had hypertension, 44% had hyperlipidemia, 26% had a smoking history, 19% were obese, and 17% had diabetes (Figure 2). Of the patients with hypertension, hyperlipidemia, and diabetes, 33%, 64%, and 23%, respectively, were newly diagnosed during stroke admission.

In a separate study in which 284 apparently healthy Hong Kong Chinese aged 40 to 65 had blood pressure monitored around the clock, about 40% were diagnosed with high blood pressure. Their average daily sodium intake was estimated at 14 g for men and 13 g for women, exceeding the World Health Organization's recommendations of no more than 5 g per day by 2.8 times and 2.6 times, respectively. In addition, sodium intake was found to be highly correlated with systolic and diastolic blood pressure as well as predicted 10-year stroke risk.

Research significance

“These alarming results call for greater awareness and control of the vascular risk factors that lead to stroke, particularly in younger generations,” commented Dr. Gary Lau Kui-kai, director of HKU Stroke, who is leading the study. "Hypertension is the leading modifiable risk factor for stroke, and previous studies have shown that for every 20 mmHg increase in systolic blood pressure or 10 mmHg increase in diastolic blood pressure, there is a 30-50% increased risk of stroke. Consistent with other studies, our results show that Chinese people tend to have very high sodium intake, which correlates directly with blood pressure and also the predicted risk of stroke. Hypertension, hyperlipidemia and diabetes are often the result of poor lifestyle and dietary habits, and measures to control these vascular risk factors through a better diet with significantly lower sodium intake, regular exercise and smoking cessation are strongly recommended for stroke prevention.'

Our results are concerning because strokes are associated with a high probability of disability and death. A stroke also has profound psychological and social consequences. This is particularly true for young people, who are often breadwinners and have to care for both older and younger family members. Our research also showed that about 30% of stroke survivors in Hong Kong suffer from moderate to severe depression, which is consistent with other studies. The social-psychological effects of a stroke should by no means be neglected.”

Dr. Gary Lau Kui-kai, Director, Stroke Research and Prevention Group, The University of Hong Kong

FAST slogan

It is crucial for the public to know the symptoms of a stroke so they can seek immediate medical attention if necessary. Delays in seeking care or not seeking care for stroke patients can be detrimental. Time is brain and for every minute that a stroke goes untreated, it is estimated that up to 1.9 million brain neurons are lost. Earlier treatment of stroke is associated with a better outcome, and any delay in seeking medical care would seriously jeopardize the stroke patient's eligibility for treatment. The FAST slogan is often used to remind the community about the symptoms of a stroke and what to do if a stroke is suspected. FAST stands for Facial Weakness, Arm Weakness, Slurring of Speech and then it's time to call for help or dial 999.

Source:

The University of Hong Kong

.