Sickle Cell Trait and Risk of Ischemic Stroke in Young Adults

Stroke. 2020 Sep;51(9):e238-e241. doi: 10.1161/STROKEAHA.119.028404. Epub 2020 Aug 12.


Background and purpose: Approximately 8% of Blacks have sickle cell trait (SCT), and there are conflicting reports from recent cohort studies on the association of SCT with ischemic stroke (IS). Most prior studies focused on older populations, with few data available in young adults.

Methods: A population-based case-control study of early-onset IS was conducted in the Baltimore-Washington region between 1992 and 2007. From this study, 342 Black IS cases, ages 15 to 49, and 333 controls without IS were used to examine the association between SCT and IS. Each participant's SCT status was established by genotyping and imputation. For analysis, χ2 tests and logistic regression models were performed with adjustment for potential confounding variables.

Results: Participants with SCT (n=55) did not differ from those without SCT (n=620) in prevalence of hypertension, previous myocardial infarction, diabetes mellitus, and current smoking status. Stroke cases had increased prevalence in these risk factors compared with controls. We did not find an association between SCT and early-onset IS in our overall population (odds ratio=0.9 [95% CI, 0.5-1.7]) or stratified by sex in males (odds ratio=1.26 [95% CI, 0.56-2.80]) and females (odds ratio=0.67 [95% CI, 0.28-1.69]).

Conclusions: Our data did not find evidence of increased risk of early-onset stroke with SCT.

Keywords: odds ratio; prevalence; risk factors; sickle cell trait; stroke; young adult.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Baltimore / epidemiology
  • Black or African American
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / genetics*
  • Case-Control Studies
  • Diabetes Complications / epidemiology
  • District of Columbia / epidemiology
  • Female
  • Genotype
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Negative Results
  • Prevalence
  • Risk Assessment
  • Sickle Cell Trait / epidemiology*
  • Sickle Cell Trait / genetics*
  • Smoking / adverse effects
  • Stroke / epidemiology*
  • Stroke / genetics*
  • Young Adult