Age and geography play an outsized role in determining a person’s likelihood of suffering stroke, according to new research. (For Spectrum Health Beat)

A quarter of the world’s people over the age of 25 will experience a debilitating stroke during their lifetime, a new study estimates.

Rates vary country to country, but in the United States 23 percent to 29 percent of people can expect a stroke sometime in their lives, concluded a team led by Dr. Gregory Roth.

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Our Take

This study highlights the growing problem of stroke in younger individuals, noted vascular neurologist Muhib Khan, MD.

“Lifestyle is a major factor related to the increase in stroke incidence globally,” said the director of the Spectrum Health Comprehensive Stroke Center.

Public health initiatives focusing on preventive care education are the key.

“Prevention through smoking cessation, weight loss and physical activity are needed to prevent stroke in the younger population,” Dr. Khan said.

He’s professor of health metrics sciences at the University of Washington in Seattle.

“These findings suggest that adults need to think about their long-term health risks, including stroke, at a much younger age,” Roth said.

For the new report, Roth and his colleagues used data from the Global Burden of Disease study to estimate the lifetime risk for having a stroke for those over the age of 25.

The investigators looked at the two major forms of stroke: ischemic strokes, caused by clots, which make up about 85 percent of strokes; and strokes caused by bleeding in the brain, called hemorrhagic strokes, which make up about 15 percent. The data came from 195 countries and spanned the years 1990 to 2016.

Looking at 2016 data, Roth’s team found that the risk of stroke for people over the age of 25 ranged from 8 percent to 39 percent, depending on where in the world they lived. The Chinese had the highest risk (with more than a 39 percent lifetime risk), followed by people in Central and Eastern Europe. The lowest risk was among those living in sub-Saharan Africa.

Gender didn’t seem to matter, with no significant differences in stroke risk seen between men and women, according to the report.

A person’s odds for a stroke rise with certain risk factors, including obesity, smoking and lack of exercise. So the new findings could help public health agencies around the world boost their public education efforts, Roth suggested.

For example, programs that encourage young adults to exercise and eat healthier diets (more fruits, vegetables and whole grains) are needed, Roth said. So are efforts that help young adults avoid smoking or excessive drinking.

“Physicians should warn their patients at a much earlier age about actions they can take to prevent stroke and other vascular diseases later in life,” Roth said.

Governments can also work to lower prices on blood pressure and cholesterol-lowering medicines, the researchers noted.

Dr. Richard Libman is vice chair of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y. He said, “Stroke remains a leading cause of disability and death worldwide. On a large scale, prevention of stroke before it ever occurs may be even more crucial in certain geographic areas, although no region is exempt from this debilitating condition.”

The report was published recently in the New England Journal of Medicine.