Can Adolescent Obesity Increase Risk for Midlife Stroke?

Authors: Sue Hughes; CME Author:Laurie Barclay, MD;

CME Released: 7/28/2017

 MEDSCAPE CLINICAL BRIEFING

For unknown reasons, stroke incidence has been increasing among young adults, in tandem with the obesity epidemic. High body mass index (BMI) in young adulthood, but not in prepubertal childhood, is a risk factor for stroke in men. However, previous studies have been limited by the availability of only 1 BMI measurement, precluding separation of the effects on stroke risk of BMI at childhood and of BMI increase through puberty and adolescence.

The goal of the population-based BMI Epidemiology Study (BEST) in Gothenburg, Sweden, was to evaluate the contribution of prepubertal childhood BMI and BMI change through puberty and adolescence to risk for adult stroke in men.

• BMI increase through puberty and adolescence is a risk marker of adult stroke, based on findings from the BEST population-based study in Gothenberg, Sweden.
• Higher BMI increases during puberty may contribute to greater risk for adult stroke at least partly via increased blood pressure.
• Implications for the Healthcare Team: Avoiding excessive BMI increase during puberty may lower the risk for adult stroke; clinicians should consider monitoring adult blood pressure in men who had excessive BMI increase during puberty.
• An accompanying editorial highlights the exponential increase in obesity in adolescents, which may predict serious health consequences later in life.
• Because overweight children who normalized their BMI by age 20 years had no long-term increased risk for stroke, it is crucial that interventions target children and adolescents to prevent overweight and obesity in early adulthood.