Obesity in adolescence linked to increased risk of stroke

Loren Bonner, senior editor

New research from the American Heart Association (AHA) shows that even after accounting for type 2 diabetes, adolescents with a higher BMI are at a significantly increased risk of first ischemic stroke.  

Researchers analyzed adolescent BMI and first stroke data before age 50 among 1.9 million men and women from two nationwide databases: the Israel Defense Forces and the Israeli National Stroke Registry. 

"Our findings underscore the importance of effective treatment and prevention of high normal and excessively high BMI during adolescence," said study co-author Gilad Twig, MD, an associate professor in the Medical Corps of the Israel Defense Forces and the department of military medicine at The Hebrew University in Jerusalem, in a news release. "Our study is also the first to show that the risk of stroke associated with higher BMI values is the same for both men and women." 

During the follow-up period between 2014 and 2018, researchers found the following among all 1.9 million participants: 

-Overall, 1,088 strokes occurred (921 ischemic strokes, 167 hemorrhagic strokes), and the average age at the time of the stroke was 41. Adolescent BMI was directly related to the risk of first ischemic stroke. 

-Compared with participants in the low to normal BMI group, adolescents who were in the overweight category had a two-times higher stroke risk before age 50, and adolescents with obesity had a 3.4-times higher risk. 

-Even adolescents with BMIs in the high to normal range were more likely to have a stroke before age 50 compared with those whose BMI was in the low to normal range. 

-After accounting for type 2 diabetes, adolescents who were in either the overweight or obesity category still had a higher risk of stroke (1.6-times and 2.4-times, respectively) compared with individuals who had BMIs within the normal range. 

Researchers noted they were surprised to find that type 2 diabetes did not explain the higher risk for ischemic stroke, which occurred even before age 30 in some participants. 

Twig said the current medical literature has shown that having a stroke early in life may lead to recurrent stroke, heart attack, long-term care, and premature death. 

The research was published in AHA’s journal Stroke on May 13.