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Obesity may increase stroke risk in young adults

Obese young adults may be more likely to have a stroke than people who aren't overweight, a US study suggests. 

Researchers studied about 2,350 residents of the greater Baltimore and Washington, DC, region and found that after accounting for age, gender and ethnicity, obesity increased the odds of a stroke for young adults by 57 percent.

Much of that added risk might be connected to smoking, high blood pressure or diabetes in addition to weight, noted senior study author Dr. Steven Kittner, a physician and neurology professor at Baltimore Veterans Affairs Hospital. Even so, he said, the findings expand on a growing body of research linking strokes to obesity and offer fresh evidence that the danger exists for younger people, not just for older adults.

"This is yet another reason to dedicate resources to reversing the obesity epidemic among children and young adults," Kittner said by email. 

More than one third of U.S. children are overweight or obese, according to the Centers for Disease Control and Prevention. Obesity has more than doubled in younger kids and quadrupled in teens over the past 30 years, the CDC estimates. 

By adulthood, more one third of Americans, or more than 78 million people, are obese, and many millions more are overweight. Obesity makes these adults more likely to have heart disease, diabetes, strokes and some types of cancer. The estimated annual medical cost of obesity exceeds $147 billion, according to the CDC. 

Kittner and colleagues compared 1,201 people who had their first stroke between the ages of 15 and 49, to a control group of 1,154 individuals who didn't have strokes but were the same gender and about the same age. 

After adjusting for age and race, obese men were 73 percent more likely to have a stroke than their normal weight counterparts. For obese women, the added risk was 46 percent.

But after also taking smoking, high blood pressure and diabetes into account, obesity was linked to only a 34 percent higher risk of stroke in men and 7 percent higher risk in women. 

Because high blood pressure and diabetes can be at least partially caused by obesity, the authors argue in the journal Stroke that the first of these two analyses is most important from a public health perspective. 

"Prevention of obesity is important since there is convincing evidence that obesity contributes to risk of diabetes and elevated blood pressure," Kittner said. 

One limitation of the study, however, is that it relied on participants to report their own height and weight, potentially underestimating the link between obesity and stroke because people who report incorrect information are more likely to underestimate than overestimate their weight, the authors note. 

Still, the findings highlight the need to recognize obesity as a risk factor for stroke in younger adults and take steps to control related conditions such as high blood pressure, Dr. Walter Kernan, a professor at Yale School of Medicine in New Haven Connecticut, wrote in an editorial published with the study. 

"If we had effective, safe treatments for obesity that were well accepted by patients and broadly available, then treating obesity rather than its consequences makes the most sense," Kernan said by email.

Without a perfect way to guarantee weight loss, clinicians should regularly assess obese patients to see if they're ready to consider a weight-loss program, he said. For the majority of obese patients who may not yet be prepared to change their diet or behavior to lose weight, regular screenings to diagnose and treat potential cardiovascular complications like hypertension are necessary, Kernan added.

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