Early vascular aging in young and middle-aged ischemic stroke patients: the Norwegian Stroke in the Young Study

PLoS One. 2014 Nov 18;9(11):e112814. doi: 10.1371/journal.pone.0112814. eCollection 2014.

Abstract

Background: Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.

Methods: We measured aortic stiffness by carotid-femoral pulse wave velocity (PWV) in 205 patients (69% men) aged 15-60 years with acute ischemic stroke in the prospective Norwegian Stroke in the Young Study. High for age carotid-femoral PWV was identified in the reference normogram.

Results: Patients were on average 49 ± 10 years old, 34% had a history of hypertension and 37% had metabolic syndrome (MetS). In the total study population, higher PWV was associated with history of hypertension (β = 0.18), higher age (β = 0.34), systolic blood pressure (BP) (β = 0.28) and serum creatinine (β = 0.18) and lower high-density lipoprotein (HDL) cholesterol (β = -0.10, all p < 0.01) in multivariate linear regression analysis (multiple R2 = 0.42, p < 0.001). High for age PWV was found in 18% of patients. In univariate analyses, known hypertension was associated with a 6-fold, MetS with a 4-fold and presence of carotid plaque with a 3.7-fold higher risk for high for age PWV (all p < 0.01). In multiple logistic regression analysis higher systolic BP (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.02-1.06; p < 0.01), history of hypertension (OR 3.59; 95% CI 1.52-8.51; p < 0.01), low HDL cholesterol (OR 3.03; 95% CI 1.00-9.09; p = 0.05) and higher serum creatinine (OR 1.04; 95% CI 1.01-1.06; p < 0.01) were associated with high for age PWV.

Conclusions: Higher PWV is common in younger and middle-aged ischemic stroke patients and associated with a clustering of classical cardiovascular risk factors. ClinicalTrials.gov NCT01597453.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Blood Glucose
  • Blood Pressure
  • Body Mass Index
  • Cholesterol, HDL / blood
  • Creatinine / blood
  • Humans
  • Hypertension / epidemiology
  • Linear Models
  • Middle Aged
  • Norway / epidemiology
  • Odds Ratio
  • Prospective Studies
  • Pulse Wave Analysis
  • Stroke / epidemiology*
  • Stroke / physiopathology*
  • Vascular Stiffness / physiology*

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Creatinine

Associated data

  • ClinicalTrials.gov/NCT01597453

Grant support

This study was financially supported by research grants from The West-Norwegian Regional Health Authority, the university, and Simon Fougner Hartmann’s Family Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.