troke rates continue to decline in people 55 and
older, while more than doubling in those between
35 and 39, according to new research in Journal
of the American Heart Association, the Open
Access Journal of the American Heart Association/
American Stroke Association.
“People, especially those under 50, need to realize that
stroke does not just occur in the old, and the outcome can
be much more debilitating than a heart attack — leaving you
living for another 30 to 50 years with a physical disability,”
said Joel N. Swerdel, M.S., M.P.H., lead study author and a
Ph.D. candidate at the Rutgers University School of Public
Health in New Brunswick, New Jersey.
For many decades stroke rates declined, an improvement
the Centers for Disease Control and Prevention attributed
to reductions in smoking, high blood pressure and high
cholesterol. However, in recent years there have been
worrisome reports that stroke rates are rising in younger
people. The current study examined that question using a
unique database that includes almost all hospitalizations for
heart disease and stroke in New Jersey.
“The beauty of this resource is that it includes all patients
over 18 years old, rather than other databases that are based
on a sample of patients or require voluntary participation from
hospitals,” said John B. Kostis, M.D., co-author of the study
and the John G. Detwiler professor of cardiology, medicine
and pharmacology in the Cardiovascular Institute at Rutgers
Robert Wood Johnson Medical School in New Brunswick.
Comparing 1995-1999 and 2010-2014, researchers
found the rate of strokes:
• more than doubled (a 2.47-fold increase) in people 35 to
39 years old;
• doubled in people aged 40 to 44;
• increased to a lesser extent in people 45 to 54 years old;
• declined in older age groups; and
• was in sharp contrast to heart attack rates, which
decreased in all age groups.
On an age-by-age basis, researchers found that people
born in the “golden generation” between 1945 and 1954 had
lower rates of stroke than those born 20 years before or after.
More research is needed to explain why Baby Boomers are
less likely to have strokes. This analysis did not have access
to data on individual risk factors such as smoking, cholesterol
levels or medication use to help explain differences in stroke
rates between groups born at different times. However, the
researchers speculated on several possible causes.
“In the golden generation, obesity was less common
than in people born earlier or later. Diabetes has been on a
continuous upswing over the last 40 years and is particularly
seen in the youngest generations. Smoking had decreased
rapidly by the golden generation but has been increasing
lately. Younger generations are also less likely to take blood
pressure or lipid-lowering medication as prescribed,” said
Swerdel, who is also manager of epidemiology analytics at
Janssen Pharmaceuticals in Titusville, New Jersey.
Differences in risk depending on birth groups also raise
questions of how early life influences risk.
“For example, while someone born in 1945 might have
eaten oatmeal or eggs for breakfast as a child, younger
generations are more likely to eat sugared cereals. No matter
what the cause, being aware of the risk in younger generations
is important to encourage people to take their prescribed
medications and strongly consider lifestyle changes, including
exercise and a better diet,” Swerdel said.
Lowest stroke rates in older Baby
Boomers; younger people rising