Adolescent Obesity Linked to Higher Stroke Risk in Women: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

This week, we reported on findings from a study published in Stroke that examined the effect of body mass index (BMI) and its changes in adolescence and young adulthood on early onset cerebrovascular disease.

The study

Researchers conducted the prospective cohort study using long-term data from participants in the Northern Finland Birth Cohort 1966 between 1980 and 2020. A total of 10 491 participants were included in the study, of whom 5185 were women.

Height, weight, and BMI measurements were taken at ages 14 and 31 years. Investigators used sex- and age-specific BMI ranges to define overweight and obesity, and they extracted data on ischemic and hemorrhagic cerebrovascular diseases between ages 14 and 54 years from national hospital and death registers. Participants were followed until their first cerebrovascular event, death, moving abroad, or the end of 2020, whichever occurred first.

The findings

Among the 10 491 participants, 452 (4.7%) experienced cerebrovascular disease during the follow-up. Of the participants who experienced cerebrovascular disease, 141 (31.2%) had ischemic strokes and 180 (39.8%) had transient ischemic attacks.

The risk of ischemic cerebrovascular disease increased for women with overweight at age 14 (HR 2.49,95% CI 1.44–4.31) and at age 31 (HR 2.13, 95% CI 1.14–3.97). Women with obesity at age 14 (HR 1.87, 95% CI 0.76–4.58) and at age 31 (HR 2.67, 95% CI 1.26–5.65) also exhibited an elevated risk of ischemic cerebrovascular disease, with normal weight as the reference. Both associations were independent of participants’ earlier or later BMI. Similar associations were not observed among men.

At age 31, women with obesity had a higher risk of hemorrhagic cerebrovascular disease (HR 3.49, 95% CI 1.13–10.7) as well as men with obesity (HR 5.75, 95% CI 1.43–23.1).

At age 14, the risk of any cerebrovascular disease related to overweight was 2.09-times higher among girls than boys (95% CI 1.06-4.15). Similarly, at age 31, investigators found that the risk of ischemic cerebrovascular disease related to obesity was 6.96-times higher among women than men (95% CI 1.36-35.7).

Authors' comment

"The association between childhood overweight and adult cerebrovascular disease is independent of overweight or obesity in adulthood, highlighting the importance for children to achieve and maintain healthy weights. The mechanisms underlying these sex-specific associations remain to be elucidated."

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