背景：目前尚不清楚常规血管危险因素是否与45岁以下患者的大多数中风有关。我们的目的是评估45岁以下人群中常见危险因素与卒中的关系。
方法：INTERSTROKE是2007年至2015年在32个国家进行的病例对照研究。在首次中风症状发作后5天内出现的患者被纳入病例。对照组的年龄和性别与病例相匹配，没有中风史。病例和对照进行了类似的评估。计算赔率比（ORs）和人群归因风险（PAR），以确定各种风险因素与所有卒中的关联。缺血性卒中,颅内出血,对于45岁或以下的患者。
结果：本分析包括1,582对病例对照。该队列的平均年龄为38.5岁（SD6.32）。总的来说,71%的中风是缺血性的。心脏原因{OR：8.42（95％置信区间[CI]：3.01-23.5）}；暴饮暴食饮酒（OR：5.44[95％CI：1.81-16.4]）；高血压（OR：5.41[95％CI：3.40-8.58]）；ApoB/ApoA1比率（OR：2.74[95％CI：1.69-4.04]）增加了年轻卒中的风险（OR对于脑出血，只有高血压(OR:9.08[95%CI:5.46-15.1])和暴饮暴食(OR:4.06[95%CI:1.27-13.0])是显著的危险因素.高血压的关联强度和人群归因风险（PAR）随年龄增长而增加（35岁以下人群的PAR为23.3％，35-45岁的50.7%）。
结论：常规危险因素，如高血压，吸烟,酗酒,中心性肥胖,心脏原因,血脂异常,心理社会压力是45岁以下人群中风的重要危险因素。高血压是所有年龄组和所有地区以及两种中风亚型中最重要的风险因素。应在成年早期识别和修改这些危险因素，以防止年轻人中风。
BACKGROUND: It is not clear whether conventional vascular risk factors are responsible for most strokes in patients younger than 45 years of age. Our objective was to evaluate the association of common risk factors with stroke in individuals under 45 years.
METHODS: INTERSTROKE was a
case-control study carried out in 32 countries between 2007 and 2015. Patients presenting within 5 days of symptom onset of a first stroke were enrolled as cases. Controls were age and sex matched to cases and had no history of stroke. Cases and controls underwent similar evaluations. Odds ratios (ORs) and population attributable risks (PARs) were calculated to determine the association of various risk factors with all stroke, ischemic stroke, and intracranial hemorrhage, for patients 45 years of age or younger.
RESULTS: 1,582
case-control pairs were included in this analysis. The mean age of this cohort was 38.5 years (SD 6.32). Overall, 71% strokes were ischemic. Cardiac causes {OR: 8.42 (95% confidence interval [CI]: 3.01-23.5)}; binge drinking of alcohol (OR: 5.44 [95% CI: 1.81-16.4]); hypertension (OR: 5.41 [95% CI: 3.40-8.58]); ApoB/ApoA1 ratio (OR: 2.74 [95% CI: 1.69-4.46]); psychosocial stress (OR: 2.33 [95% CI: 1.01-5.41]); smoking (OR: 1.85 [95% CI: 1.17-2.94]); and increased waist-to-hip ratio (OR: 1.69 [95% CI: 1.04-2.75]) were the most important risk factors for ischemic stroke in these young cases. For intracerebral hemorrhage, only hypertension (OR: 9.08 [95% CI: 5.46-15.1]) and binge drinking (OR: 4.06 [95% CI: 1.27-13.0]) were significant risk factors. The strength of association and population attributable risk (PAR) for hypertension increased with age (PAR 23.3% in those <35 years of age, 50.7% in 35-45 years of age).
CONCLUSIONS: Conventional risk factors such as hypertension, smoking, binge drinking of alcohol, central obesity, cardiac causes, dyslipidemia, and psychosocial stress are important risk factors for stroke in those younger than 45 years of age. Hypertension is the most significant risk factor in all age groups and across all regions and both stroke subtypes. These risk factors should be identified and modified in early adulthood to prevent strokes in young individuals.
