Spending teenage years in the ‘stroke belt’ seems to increase risk
Spending adolescence in the “stroke belt” of the southeastern United States could make people more vulnerable to stroke later in life – even if they eventually move elsewhere, a study published Wednesday suggests.
What researchers call the “stroke belt” has been associated with higher rates of death from stroke than other parts of the country, but it hadn’t been known if living there during any particular stage of life had an effect.
Researchers led by Virginia Howard of the University of Alabama looked at 24,544 black and white people ages 45 and older who were part of a national study that considered geographic and racial differences in the incidence of stroke.
The strongest association existed for people who spent their entire lives in the stroke belt, but after adjusting for risk factors, only one age – 13 to 18 – still had a significant association.
The reasons are not certain, but the researchers speculated that adolescence is a time when many people set in place certain important habits – smoking, dietary choices – that affect stroke risk.
“Many adolescents make decisions about education, marriage and work that will impact their social context for the rest of their lives,” the researchers wrote in the study published in the journal Neurology.
The participants were divided into four groups, based on whether they were born in the Southeast and what portions of their lives were spent there. The highest risk of stroke existed for people who were born in the region and lived there at the time of the study, followed by those who were born in the Southeast but lived elsewhere at the time of the study.
Once the researchers adjusted for age, sex and race, the risk for stroke was higher only for teens – 17% higher.
In an accompanying editorial, Luis Castilla-Guerra of the University of Seville in Spain and Ali Mokdad of the University of Washington in Seattle note that there is “increasing evidence for a link between a broad category of environmental factors and stroke, such as air pollution, environmental tobacco smoke, metals, pesticides and many others.” That might fuel speculation about early life geography and stroke risk, they said.
They also noted the life choices teenagers make.
“Future research must pinpoint how early life environment and lifestyle factors have lasting effects on stroke risk. However, this and many other studies call for community and environmental strategies to prevent stroke to start earlier in life,” they wrote.
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