Stroke In The Young

Introduction/Background/

Literature Search

A stroke, or cerebrovascular aacident is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular disease. Its definition is clinical and is supported by the diagnostic examinations including brain imaging (Harrsion, 2009). There is considerable increased in the number of patients developing Cerebrovascular Diseases despite the efforts of the different health organizations in the prevention of this disease. It is the second most common causes of mortality here in the Philippines both in male and in female. This disease is also the leading cause of disability in our country (DOH, 2015). Stroke in young population is not common as what other literatures are reporting. However based on our census, there are an increasing number of young adults developing this disease. Stroke in the Young is commonly define as young adults younger than 45 or 49 years who had Stroke (Smajlović, 2015).

The nature and the etiologic factors contributing to the development of stroke in young adults may vary from that in older patients (Smajlović, 2015). This will affect the diagnostic evaluation and treatment of this disease. A lot of studies have been published on the relationship between stroke and smoking. Possible mechanisms on how cigarette smoking contributes to the development of stroke include increased fibrinogen levels, carboxyhemoglobinemia, reduced HDL-cholesterol, increased platelet aggregability, and direct toxic effects of compounds constituent of a cigarette increasing the development of atherosclerosis (Shah et al. 2015). The correlation between exposure to cigarette smoke and progression of atherosclerosis was demonstrated using a B-mode ultrasound of the carotid wall and endothelium-dependent brachial artery dilatation indicating a damaged endothelium (Shah et al. , 2015).

Although the increased risk of stroke associated with smoking is generally acknowledged, there are a few studies demonstrating a dose–response relationship between smoking and stroke (Sha et al. , 2010). In A study done by Gan et al. ,(2018) showed that increased probability of stroke in cigarette smokers was increased by the number of cigarettes and duration in years that the patient smoked. A meta-analysis was done across various ethnicities and populations which showed that smokers have at least a two- to fourfold increased risk of stroke compared with nonsmokers or individuals who had quit smoking more than 10 years prior (Shah et al. ,2010).

Although the impacts of smoking on health are well recognized, it is yet to establish how they affect the young Filipino population. This study aimed to investigate the association between pack years cigarette smoking and the risk of stroke in Young Adults ages 19-45 years old.

Rationale/ Relevance of the Study

Stroke is the second/third leading cause of death worldwide with an estimated fourteen percent rise in the mortality rate in ten years from two thousand and five to two thousand and fifteen and an increased to thirty percent in the year twenty thirty. Stroke in the young has a dis¬proportionately large economic impact in comparison to older adults making the younger victims disabled they reached their most productive years. (Smajlović, 2015). Increasing in the incidence of stroke in the young adults have been a growing concern that is why research studies were generated to find out the risks factors contributing to the development of this disease.

It is already established that cigarette smoking is a well-established risk factor for all forms of stroke however the use of tobacco had remained prevalent with its initiation occurring during the teenage years (Sha, 2010). The primary prevention is important with regard to stroke in young adults, and aggressive treatment of risk factors for stroke, including smoking is relevant. Also the secondary stroke prevention focuses on the stroke etiology and the management of risk factors (Smajlović, 2015). Thus, this is study is timely for it will contribute knowledge on the dose dependent relationship of cigarette smoking to the development of stroke in the young patients. This would help to emphasize the detrimental effect of cigarette smoking both to the individual and the society as a whole (Sha, 2010).