Deans' stroke musings: Teen Weight Rise Tied to Adult Stroke Risk Swedish study links rising teen BMI to later ischemic stroke, ICH in men

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, June 29, 2017

Teen Weight Rise Tied to Adult Stroke Risk Swedish study links rising teen BMI to later ischemic stroke, ICH in men

I really hate these research items identifying an additional small stroke risk. We should be solving all these problems in stroke instead. A stroke strategy would take care of that, but since we have NO stroke leadership we have NO strategy.
https://www.medpagetoday.com/Neurology/Strokes/66327?

by Kristin Jenkins, Contributing Writer, MedPage Today June 28, 2017
This article is a collaboration between MedPage Today® and:

Action Points

An increase in BMI in boys through puberty and adolescence is associated with significantly increased risk of ischemic stroke and intracerebral hemorrhage (ICH) during their adult years, according to a Swedish observational study.
Be aware that rates of obesity are continuing to climb in U.S. children and adolescents: In adolescents, obesity rates have doubled (10.5% to 20.5%) and rates of extreme obesity have quadrupled (2.6% to 9.1%) between 1988-89 and 2014-15.

Boys who were overweight during puberty and adolescence had a significantly increased risk of ischemic stroke and intracerebral hemorrhage (ICH) during their adult years compared to peers with a body mass index (BMI) in the normal range, researchers found.
Retrospective analysis of height and weight measures from school and military records and long-term stroke follow-up data in Swedish men revealed that a BMI increase of 2 kg/m² from ages 8 through 20 was associated with a 21% increased risk of total stroke in adulthood (HR 1.21 per SD increase), according to Jenny Kindblom, MD, PhD, of the University of Gothenburg in Sweden, and colleagues.
In addition, the risk of ICH was increased by 29% for each 2 kg/m² increase in BMI (HR 1.29 per SD increase), and the risk of ischemic stroke rose by 19% (HR 1.19 per SD increase), they reported online in Neurology.
A large increase in BMI during puberty and adolescence was also associated with a 35% increased risk of adult hypertension (OR 1.35 per SD increase), making it a probable mediating factor, the researchers said.
The good news? In boys who were overweight at age 8 but whose BMI normalized by age 20, there was no increased risk of stroke during adulthood, they reported.
"The observational nature of our study precludes making conclusive statements about the observed associations, but our findings can be useful for hypothesis generation," the researchers wrote. "Based on our findings in the present study, we hypothesize that avoiding excessive BMI increase during puberty might reduce the risk of adult stroke and that one should consider monitoring adult blood pressure in men with excessive BMI increase during puberty."
Although a high BMI in adulthood is a risk factor for stroke, there is no clear evidence of an association between prepubertal BMI and adult risk of stroke, the study authors said. "All these previous studies had only one BMI measurement available and could not separate the effect of BMI at childhood and the effect of BMI increase through puberty and adolescence for stroke risk," they wrote.
Only BMI increase through puberty and adolescence was independently associated with risk of adult stroke, they emphasized. Sub-analysis showed that a large BMI increase during puberty was a moderate risk marker of ischemic stroke in adult men whether they were younger or older than 55 years. It also was a substantial risk marker for early adult ICH and a strong predictor of adult hypertension.
For the study, the investigators used data from the population-based BMI Epidemiology Study (BEST) of 37,669 men born between 1945 and 1961 in Gothenburg, Sweden.
Men with information on BMI both at age 8 and at age 20 were followed until December 2013, for an average of 38 years.
Information on stroke events from national registries showed that there were 918 first stroke events, 672 ischemic stroke events, and 207 ICH events. Data also showed that:

In 33,511 men of normal weight at both age 8 and age 20, 779 had a stroke (2.3%)
In 1,800 men whose weight was normal at age 8 but who were overweight at age 20, 67 had a stroke (3.7%)
In 1,368 men who were overweight at age 8 and of normal weight at age 20, 36 had a stroke (2.6%)
In 990 men who were overweight at both time points, 36 had a stroke (2.6%)

Previously, Kindblom and colleagues analyzed BEST data to demonstrate that excessive BMI increase during puberty was a risk marker of cardiovascular mortality in adulthood.
In an accompanying editorial, Kathryn Rexrode, MD, MPH, of Harvard Medical School, and Sue Kimm, MD, MPH, an epidemiology consultant in Santa Fe, N.M., said this study demonstrates the clinical significance of BMI changes during adolescence -- "a relatively quiescent time in medical surveillance."
"These findings emphasize the need to target interventions for children and adolescents to prevent overweight and obesity in early adulthood and also reduce future cardiovascular morbidity," they wrote. "Battling childhood and adolescent obesity is the first step toward prevention of stroke and major adult chronic diseases."
The study's findings offer a potential explanation for the sharp increases in the incidence of stroke at mid-life in the U.S., Rexrode and Kimm pointed out, noting that the incidence of stroke in women ages 35-54 has tripled over the past 20 years, corresponding to epidemic rises in obesity.
Rates of obesity are continuing to climb in children and adolescents in the U.S., from age 6 right through age 19. In adolescents, obesity rates have doubled (10.5% to 20.5%) and rates of extreme obesity have quadrupled (2.6% to 9.1%), a development that "portends serious health consequences later in life," the editorialists said.
Limitations of the study included the fact that no information on childhood socioeconomic factors or education was available and researchers couldn't control for risk factors such as smoking, exercise, serum blood lipid levels, or BMI at middle age. In addition, the cohort was comprised primarily of Caucasian men and the prevalence of obesity in the cohort was relatively low compared to today's rates.

This study was funded by the Swedish Research Council, the Swedish Agreement for Medical Education and Research, the Lundberg Foundation, the Torsten Söderberg Foundation, the Novo Nordisk Foundation, the Knut and Alice Wallenberg Foundation, and the Anna Ahrenberg Foundation. The study authors and the editorialists reported no conflicts of interest.