Early Vascular Aging in Young and Middle-Aged Ischemic Stroke Patients: The Norwegian Stroke in the Young Study

• DOI: 10.1371/journal.pone.0112814
• Publication Date: 2014-11-18T19:25:00Z
• Authors: Sahrai Saeed; Ulrike Waje-Andre...; Annette Fromm; Halvor Øygarden; Marina V. Kokorina; Halvor Naess; Eva Gerdts
• Keywords: Adult; Blood Glucose; Adolescent; Science; 610; :Medisinske fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 [VDP]; Blood Pressure; Pulse Wave Analysis; Body Mass Index; 03 medical and health sciences; Vascular Stiffness; 0302 clinical medicine; Odds Ratio; Humans; Prospective Studies; VDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752; :Medical sciences: 700::Clinical medical sciences: 750::Neurology: 752 [VDP]; Norway; VDP::Medical sciences: 700::Clinical medical sciences: 750::Neurology: 752; Q; Cholesterol, HDL; R; Age Factors; Middle Aged; VDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771; 3. Good health; :Medical sciences: 700::Clinical medical sciences: 750::Cardiology: 771 [VDP]; Stroke; Creatinine; :Medisinske fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752 [VDP]; Hypertension; Linear Models; Medicine; VDP::Medical sciences: 700::Clinical medical sciences: 750::Cardiology: 771; Research Article

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.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.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.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.