NLM Director’s Comments Transcript
Early Stroke Increases Mortality Risk: 05/20/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

A stroke or mini-stroke before age 50 significantly increases a survivor’s risk of death compared to stroke-free peers, suggests a study from Holland recently published in the Journal of the American Medical Association.
Specifically, the study finds for 30-day survivors the cumulative 20-year mortality risk is 25 percent for young adults who experience a mini-stroke. The comparative risk of death is 27 percent for survivors whose stroke is caused by a blockage in a blood vessel, and the mortality risk increases nearly 13 percent for young adults with bleeding, or ‘hemorrhagic’ strokes.
The study finds the mortality rates among young adult - stroke survivors rise three percent after one year, 12 percent at 10 years, and 27 percent at 20 years. Overall, the comparative mortality risk is from 2.6 to 3.9 times higher for stroke survivors under age 50.
The study’s seven researchers found all of the aforementioned increases are significantly higher than the expected mortality among other young adults.
The study’s findings are derived from a larger study that followed an array of health outcomes for stroke and mini-stroke survivors from ages 18-50 in the Netherlands. The researchers followed 969 survivors, who experienced a stroke or mini-stroke (called a transient ischemic attack) and were treated at a medical facility in Holland between January 1980 and November 2010. The mean follow up period for the stroke survivors in the study was about 11 years.
The research also suggests the underlying vascular disease associated with strokes and mini-strokes may increase the comparative risk of disease and mortality among young adult survivors. The researchers told Health Day (and we quote): ‘the underlying (vascular) disease that caused the stroke at relatively young age continues to put these patients at an increased risk for vascular disease throughout their lives’ (end of quote).
An editorial that accompanies the study suggests there may be two reasons for the increased mortality risks among younger stroke survivors. First, the editorial notes a stroke survivor’s underlying illness may not be diagnosed accurately or managed successfully. Second, some unhealthy risk factors in a stroke survivor’s lifestyle (such as smoking, alcohol and drug abuse, physical inactivity and hypertension) may not be remedied.
The editorial’s author adds stroke is increasingly considered a condition that impacts younger adults. The editorial’s author writes (and we quote): ‘The mean age of stroke is declining and is now 69 years; the proportion of all strokes among persons younger than 55 years is increasing and is 19%, and the incidence rates of stroke among 20-54 year olds is increasing in the United States and United Kingdom...’(end of quote).
The editorial concludes the study’s findings imply future efforts to reduce the burden of stroke among young adults (and we quote) ‘should extend beyond acute treatment and early secondary prevention into the long term’ (end of quote).
MedlinePlus.gov’s stroke health topic page explains a stroke occurs when the blood flow to your brain either stops or is briefly interrupted. Similar to the distinctions within the current study, MedlinePlus.gov’s stroke health topic page explains a mini-stroke is when there is a brief interruption of blood supply to the brain. A stroke is either ischemic (caused by a blood clot) or is hemorrhagic (caused by a blood vessel that breaks and bleeds into the brain).
MedlinePlus.gov’s stroke health topic page provides an array of information about stroke diagnosis/symptoms, treatment, prevention/screening, and recovery. An interesting website from the National Stroke Association stresses the importance of eating healthy foods to promote survivor recovery. The site, which is found in the ‘nutrition’ section, notes from 8-34 percent of stroke survivors suffer from malnutrition.
MedlinePlus.gov’s stroke health topic page contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the stroke health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.
To find MedlinePlus.gov’s stroke health topic page, just type ‘stroke’ in the search box at the top of MedlinePlus.gov’s home page. Then, click on ‘stroke (National Library of Medicine).’ MedlinePlus.gov also has health topic pages devoted to transient ischemic attack and stroke rehabilitation.
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