Background and Purpose-We compared among young patients with ischemic
stroke the distribution of vascular risk factors among sex, age groups,
and 3 distinct geographic regions in Europe.
Methods-We included patients with first-ever ischemic stroke aged 15 to
49 years from existing hospital-or population-based prospective or
consecutive young stroke registries involving 15 cities in 12 countries.
Geographic regions were defined as northern (Finland, Norway), central
(Austria, Belgium, France, Germany, Hungary, The Netherlands,
Switzerland), and southern (Greece, Italy, Turkey) Europe. Hierarchical
regression models were used for comparisons.
Results-In the study cohort (n=3944), the 3 most frequent risk factors
were current smoking (48.7%), dyslipidemia (45.8%), and hypertension
(35.9%). Compared with central (n=1868; median age, 43 years) and
northern (n=1330; median age, 44 years) European patients, southern
Europeans (n=746; median age, 41 years) were younger. No sex difference
emerged between the regions, male: female ratio being 0.7 in those aged
<34 years and reaching 1.7 in those aged 45 to 49 years. After
accounting for confounders, no risk-factor differences emerged at the
region level. Compared with females, males were older and they more
frequently had dyslipidemia or coronary heart disease, or were smokers,
irrespective of region. In both sexes, prevalence of family history of
stroke, dyslipidemia, smoking, hypertension, diabetes mellitus, coronary
heart disease, peripheral arterial disease, and atrial fibrillation
positively correlated with age across all regions.
Conclusions-Primary preventive strategies for ischemic stroke in young
adults-having high rate of modifiable risk factors-should be targeted
according to sex and age at continental level. (Stroke. 2012;
43:2624-2630.