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Study Pinpoints Risk Factors for Death in Young Stroke Victims

Many can be modified, treated to improve odds, experts say,,

THURSDAY, July 9 (HealthDay News) -- Younger adults who suffer a stroke are more likely to die if they are heavy drinkers, have heart failure, cancer, type 1 diabetes or an infection before their stroke, Finnish researchers report.

Although the overall death rate in stroke patients aged 15 to 49 is low, four factors double the risk of death: heavy drinking; being 45 to 49; type 1 diabetes; or a having an infection beforehand. Moreover, having heart failure increased the risk of dying sevenfold and cancer increased the risk 16 times, the researchers found. The overall death rate at five years was 10.7 percent.

"There are no big surprises here," said Dr. S. Claiborne Johnston, director of the Clinical and Translational Science Institute at the University of California, San Francisco.

"Young people with strokes have lower mortality rates than the elderly, in whom one-year rates are more typically in the 14 percent range. These are young people who die mostly from cardiac causes, the most common cause of death, so it shows how strongly the risk factors for stroke and heart disease converge," he said.

The report in published in the July 9 online edition of Stroke.

In the study led by Dr. Jukka Putaala, from the Department of Neurology at Helsinki University Central Hospital in Finland, the researchers collected data on 731 patients aged 15 to 49 who suffered a stroke from January 1994 to September 2003. Among these patients, 78 died.

Those who were 45 or older at the time of their stroke were less likely to survive, the researchers found. Among the patients who died, 21 percent died of their stroke, 36 percent died from heart failure or another heart problem, 12 percent died from cancer and 9 percent died from previous infections. In addition, heavy drinking accounted for an increased risk of dying after a stroke, the team found.

These factors independently predicted survival at five years after taking into account age, sex, other risk factors, the severity of the stroke and the type of stroke, the researchers noted.

"Despite the overall low risk of death in the young after the first-ever ischemic stroke, several easily recognizable factors associate independently with the long-term mortality," the researchers write. "Regarding young adults with a long expected life span ahead, detecting these factors are important, because in most patients, they can be modified by lifestyle changes, strictly controlled medication or invasive interventions, when indicated," they conclude.

Dr. Argye Hillis, an associate professor of neurology at Johns Hopkins University, said that other studies have found that the most common cause of death after a stroke is a heart condition.

To increase the chances of surviving a stroke, Hillis recommends living a healthy lifestyle. "Don't smoke, keep your blood pressure controlled, eat well, exercise -- all the things we know are good for the heart are also good for stroke patients and prevent death after stroke," she said.

In addition, to prevent another stroke, many of these patients take aspirin or other blood thinners, Hillis said.

More information

For more on stroke, visit the American Stroke Association.

SOURCES: Argye Hillis, M.D., associate professor, neurology, Johns Hopkins University, Baltimore; S. Claiborne Johnston, M.D., Ph.D., director, Clinical and Translational Science Institute, University of California, San Francisco; July 9, 2009, Stroke, online

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