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Teenage Years in the “Stroke Belt” Drive Up Risk

Adolescence is inarguably a vulnerable time of life, but a new study suggests that spending it living in the southeastern United States region known as the “Stroke Belt” adds an extra hazard: It raises one's risk of stroke later in life.

In a large population-based study funded by the National Institute of Neurological Disorders and Stroke (NINDS), people who spent their teenage years (ages 13-18) living in the Stroke Belt had a 17% higher risk of stroke than those who spent no time living in the region.

The magnitude of harm from Stroke Belt living was greater among blacks than among whites. Compared to study volunteers who spent no time living in the Stroke Belt, a lifetime in the region increased stroke risk by 35% among blacks and by 15% among whites. Blacks who spent only their adolescence in the Stroke Belt were at 33% greater risk; whites had a 15% higher risk.

Researchers followed 24,544 black and white people of a mean age of 65 and who were stroke-free at the start of the study. During the next six years, 615 study participants suffered their first stroke.

Adolescence is a malleable period during which unhealthy lifestyle choices get established, said the study's lead investigator Virginia J. Howard, Ph.D., of the University of Alabama at Birmingham. People who smoke, for example, often start during their teenage years. At the same time, “areas of the Southeast have been shown to have among the lowest levels of healthy behaviors such as regular physical activity and the highest prevalence of cardiovascular factors, such as hypertension and obesity,” she wrote.

“The findings underscore the need for stroke prevention strategies that reach adolescent and young adult populations,” said Claudia S. Moy, Ph.D., program director at NINDS, which funds the ongoing population-based study known as Reasons for Geographic and Racial Differences in Stroke (REGARDS).

Dr. Howard and her colleagues analyzed data from REGARDS, which were published April 24, 2013 in the online issue of Neurology.


National Institute of Neurological Disorders and Stroke (NINDS)

Howard V. et al., “Effect of duration and age at exposure to the stroke belt on incident stroke in adulthood.” Neurology, 2013 April 30:80(18):1655-61. Published online April 24, 2013.

May 17, 2013

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