Vascular Risk Factors Among Black Vs. White Young Adults with Ischemic Stroke

The incidence of ischemic stroke in young adults is increasing, a change attributable at least in part to the increasing prevalence of vascular risk factors in younger age groups. The extent to which the excess risk for stroke observed in Black people, particularly Black young adults, is also driven by differences in the prevalence of multiple concurrent vascular risk factors between Black and white young adults is unclear. To shed light on this question, investigators identified 1034 incident ischemic stroke cases aged 15 to 49 years in one urban area and 1091 non-stroke controls matched by age, sex, and region of residence, and for most cases by race as well, enrolled as part of the Stroke Prevention in Young Adults Study from 1992 through 2007.

Each individual vascular risk factor examined — current smoking, diabetes mellitus, hypertension, and obesity — as well as low education status (<12 years) was more prevalent among Black than white patients. Black people were about 6 times more likely than white people to have all 4 risk factors, and higher numbers of risk factors were seen in men versus women. Stroke incidence increased exponentially as the number of vascular risk factors increased for both Black and white people (one risk factor odds ratio, 2.1; two risk factors OR, 2.6; three risk factors OR, 7.6; four risk factors OR, 16.5).