Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach.

Authors:
Jiri Polivka
Jiri Polivka
Charles University in Prague and Faculty Hospital Plzen
Martin Pesta
Martin Pesta
Charles University in Prague
Czech Republic
Vladimir Rohan
Vladimir Rohan
Charles University in Prague
Czech Republic
Libuse Celedova
Libuse Celedova
Charles University
Ondrej Topolcan
Ondrej Topolcan
Laboratory of Immunoanalysis
Olga Golubnitschaja
Olga Golubnitschaja
Rheinische Friedrich-Wilhelms-University of Bonn
Germany

EPMA J 2019 Mar 20;10(1):81-99. Epub 2019 Feb 20.

8Radiological Clinic, UKB, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.

Stroke is one of the most devastating pathologies of the early twenty-first century demonstrating 1-month case-fatality rates ranging from 13 to 35% worldwide. Though the majority of cases do occur in individuals at an advanced age, a persistently increasing portion of the patient cohorts is affected early in life. Current studies provide alarming statistics for the incidence of "young" strokes including adolescents. Young stroke is a multifactorial disease involving genetic predisposition but also a number of modifiable factors, the synergic combination of which potentiates the risks. The article analyzes the prevalence and impacts of "traditional" risk factors such as sedentary lifestyle, smoking, abnormal alcohol consumption, drug abuse, overweight, hypertension, abnormal sleep patterns, and usage of hormonal contraceptives, among others. Further, less explored risks such as primary vascular dysregulation and associated symptoms characteristic for Flammer syndrome (FS) are considered, and the relevance of the FS phenotype for the stroke predisposition at young age is hypothesized. Considering the high prevalence of known genetic and modifiable risk factors in the overall predisposition to the young stroke, the risk mitigating measures are recommended including innovative screening programs by application of specialized questionnaires and biomarker panels as well as educational programs adapted to the target audiences such as children, adolescents, and young adults.

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Source
http://dx.doi.org/10.1007/s13167-019-00162-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459458PMC
March 2019
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