Younger adults who suffered a stroke were often smokers or had abused
drugs or alcohol, in a new study from Ohio and Kentucky.
Although strokes are often
thought of as a condition of the elderly, researchers said long-term changes in
the heart, arteries and blood as a result of drug abuse or heavy drinking may
put users at higher-than-average risk earlier in life.
It's also possible that some
drugs, particularly cocaine and methamphetamines, may trigger a stroke more
immediately, according to Dr. S. Andrew Josephson, a neurologist from the
University of California, San Francisco, who has studied drug use and stroke.
Because substance use is common
in older adults as well, he said doctors should ask anyone who's had a stroke
about drugs and alcohol.
But, "we know that even with
vascular risk factors that are prevalent - smoking, high blood pressure… most
people still don't have a stroke until they're older," Josephson, who was
not involved in the new study.
"When a young person has a
stroke, it is probably much more likely that the cause of their stroke is
something other than traditional risk factors."
According to the Centers for
Disease Control and Prevention, close to 800,000 people in the United States
have a stroke every year, and strokes are the most common cause of serious
long-term disability.
One study of 2007 data found that
almost five per cent of people who had a stroke that year were between ages 18
and 44.
The current study included people
from Greater Cincinnati and Northern Kentucky who'd had a stroke before they
hit 55.
Dr. Brett Kissela from the
University of Cincinnati and his colleagues reviewed medical charts for blood
or urine test results or other records of substance abuse for close to 1,200
stroke patients.
In 2005, the most recent year
covered, just over half of younger adults who suffered a stroke were smokers at
the time, and one in five used illicit drugs, including marijuana and cocaine.
Thirteen per cent of people had
used drugs or alcohol within 24 hours of their stroke, according to findings
published in the American Heart Association journal Stroke.
"The rate of substance
abuse, particularly illicit drug abuse, is almost certainly an underestimate
because toxicology screens were not obtained on all patients," said Dr.
Steven Kittner, a professor of neurology at the University of Maryland School
of Medicine in Baltimore who also wasn't part of the research team.
"It's certainly underreported,"
he told Reuters Health.
The rate of smoking, drug use and
alcohol abuse - defined as three or more drinks per day - seemed to increase
among stroke patients between the mid-1990s and the mid-2000s.
But Kissela and his team said
they can't be sure whether more people were actually using those substances or
doctors were just getting better at testing for and recording drug abuse.
The study also can't prove that
patients' drug or alcohol use directly contributed to their strokes. It's
possible, for example, that people who abuse drugs also see their doctors less
often or engage in other risky behaviours that increase their chance of stroke,
Josephson explained.
He said the study emphasizes the
importance of learning and quickly recognising the signs of a stroke - such as
weakness on one side of the body and dizziness - even for young people. Some
treatments can only be used during a short "window of opportunity"
after the stroke.
"We see patients all the
time who have symptoms that are classic for a stroke… and those symptoms are
not recognised as being stroke symptoms because of the idea that, 'Well, that's
something that happens only to older people,'" he said.
Reuters
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