Jonathan Solomonow1, Karen Yarbrough1, Seemant Chaturvedi1, Prachi Mehndiratta1
1University of Maryland
Objective:
Our aim was to identify the association of obesity with young acute ischemic stroke (AIS), and the burden of lifestyle-related risk factors based on different body-mass-index (BMI) categories in patients with young AIS.
Background:
Obesity is a known risk factor for AIS in both the adult and young (<50 years) population. Prior studies suggest that this association is mediated through risk factors such as diabetes and hypertension; however, the extent of this association has not been reported.
Design/Methods:
All patients with AIS, younger than 50 years, admitted to the University of Maryland hospital system hospitals Jan 2017 and December 2020, were included. Patients were categorized into 3 BMI categories: 1) Normal (18.5-24.9), 2) Overweight (25-29), and 3) Obese (≥30). Lifestyle-related risk factor (HTN, DM, DLD, and sleep apnea) burden and distribution was analyzed across the three groups using Chi-squared tests of association. One-way Welch’s ANOVA was utilized to test mean differences in number of risk factors across BMI categories.
Results:
We identified 1272 patients with young stroke. A total of 797/1272 (63%) of our young stroke patients were obese and 23.1% (n=294) were in the overweight category. In the obese category: mean age was 41.4 years (SD +/- 6.75), 49.4% were women and 53.4% were Black. Risk factor burden was significantly higher in the obese vs. the overweight and normal weight categories (p = <0.001). The proportion of patients with HTN, DM, DLD and sleep apnea was significantly higher in the obese category.
Conclusions:
A majority of young stroke patients were obese, and the obese and overweight patients were predominantly African American. Obese patients had the highest proportion of all medical risk factors, as well as a risk factor burden nearly twice as high as those with normal BMI. Efforts to reduce obesity hold promise in mitigating the burden of stroke in young adults.