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The Changing Trends in Age of First-Ever or Recurrent Stroke in A Rapidly Developing Urban Area during 19 Years

Jae-Sang Oh, Hack-Gun Bae, Hyung Geun Oh, Seok-Mann Yoon, Jae-Won Doh and Kyeong-Seok Lee

Background: To evaluate the trends in age of stroke and compare with recent national wide data in a rapidly developing urban area over the 19 years from 1997 to 2015.

Methods: We recruited 12,370 patients who were diagnosed from 1997 to 2015 with first-ever or recurrent stroke in our hospital, which is located in the center of Chungnam. We assessed the trends in mean age of first-ever or recurrent stroke by sex. In addition, we compared the trends in stroke by age and sex between our patient populations. We calculated trends in mean age of first-ever or recurrent stroke by sex and stroke subtype using a regression model.

Results: Of total 12.370 patients, IS (ischemic stroke) were 64% and HS (hemorrhagic stroke) were 36%. The ratio of SAH (subarachnoid hemorrhage) in young age (<45), middle age (45~64), and old age (>64) group were 38%, 22%, and 13%, respectively. The ratio of IS in young age, middle age, and old age group were 41%, 58%, and 72%, respectively. From 1997 to 2009, the mean age of stroke onset increased annually by 0.10 year for overall stroke and by 0.32 year for IS, while that of HS onset significantly decreased annually by 0.25. From 2010 to 2015, the mean age of stroke onset increased annually by 0.34 year for overall stroke, by 0.03 year for IS, and by 0.72 year for HS. Since 2009, the campaign of health check-up widened to young and middle age population and to obtain the focused care and control for risk factors of stroke. During 19 years, the proportions of the middle age people in Chungchungnam-do increased steadily among both sexes (men; 20% in 1996 to 30% in 2015, women; 22% in 1996 to 28% in 2015).

Conclusion: The stroke age trends tend to increase in rapidly developing urban areas, while that of hemorrhagic stroke showed a decreasing tendency. However, the mean age of HS began reversing to older age since health policy established and the proportion of population was changed with hyper-aging society. The stroke age trends are affected by many factors, so prevention of stroke, such as campaign or health check-up service, should be focused on the young and middle age population to prevent these trends.