According to study author George Howard, Dr PH, of the University of Alabama at Birmingham School of Public Health, "high blood pressure and diabetes are two important risk factors for stroke that can be managed by medication, decreasing a person's risk." While other risk factors do not alter with age, our findings indicate that their association with stroke risk may be significantly lower at older ages. Because of these disparities in risk factors, age may play a role in determining whether a person is at risk for stroke.
The review affected 28,235 individuals who had never suffered a heart attack. 59% of this group was white, while 41% of them were Black. On average, participants were followed for 11 years.
Participants were given interviews and physical examinations to assess risk factors at the beginning of the study. Heart disease, diabetes, smoking, atrial fibrillation, and left ventricular hypertrophy—the thickening of the heart's left ventricle—were all risk factors. Howard added that race was also taken into account as one of the assessed risk factors because Black people are known to have a higher risk of having a stroke.
Every six months, the researchers checked on participants and found strokes by looking at their medical records.
Over 276,074 person-years, there were 1,405 strokes during the study. The number of people participating in the study and the amount of time they spend there are both represented by person-years.
After that, the three age groups of participants were compared. Depending on the data being analyzed by researchers, those age ranges varied slightly. In general, participants in the younger group ranged in age from 45 to 69, while those in the middle group were in their late 60s to 70s and those in the older group were 74 and older.
According to the findings, people with diabetes in the younger age group had a stroke risk that was approximately twice as high as that of people of a similar age who did not have diabetes. On the other hand, people with diabetes in the older age group had a stroke risk that was approximately 30% higher than that of people of a similar age who did not have diabetes.
In addition, the researchers discovered that whereas people with high blood pressure in the younger age group had a risk of stroke that was 80% higher than that of people of a similar age who did not have high blood pressure, those with high blood pressure in the older age group only had a risk of stroke that was 50% lower than that of people of a similar age who did not have high blood pressure.
Black participants in the younger age group had a higher stroke risk than white participants in that age group when researchers looked at race as a risk factor. In the older age group, the disparity in race decreased. Researchers found no age-related risk change for stroke risk factors like smoking, left ventricular hypertrophy, and atrial fibrillation.
According to Howard, "It is important to note that our results do not suggest that treatment of high blood pressure and diabetes becomes irrelevant in older age." For a person's health, such treatments are still very important. However, doctors might also be wise to focus on controlling risk factors like smoking, left ventricular hypertrophy, and atrial fibrillation as people get older.
Howard also made the observation that, despite the fact that the influence of risk factors decreases with age, the total number of people who suffer from strokes at older ages may still be higher because the overall risk of stroke rises with age. For instance, researchers estimate that, compared to 3.6% of people with high blood pressure, 2.0% of people in the younger age group with normal blood pressure had a stroke. Compared to 9.3% of people with high blood pressure, about 6.2% of older people with normal blood pressure had a stroke.
The fact that participants' risk factors were only evaluated once at the beginning of the study raises the possibility that they have changed over time, which is a limitation of the research.
The National Institutes of Health, including the National Institute on Aging and the National Institute of Neurological Disorders and Stroke, provided financial support for the study.
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