Acidente vascular cerebral em adultos jovens no Brasil: prevalência e fatores de risco metabólicos e comportamentais de saúde: pesquisa nacional de saúde-2019

Abstract

Although the prevalence of stroke (AVC) is higher in individuals over seventy years old, the incidence and mortality of stroke in individuals aged 15 to 49 have been increasing in recent decades worldwide. The Brazilian Stroke Society defines stroke in young adults as occurring in individuals <50 years old. In this profile, the presence of disability contributes to socio-economic and public health problems. The aim of this study was to estimate and compare the prevalence of stroke and metabolic and behavioral health risk factors in young adults in Brazil and its regions (South, Southeast, Midwest, North, and Northeast). This was a cross-sectional study using publicly available population-based data from young adults (18 to 50 years old) with self-reported stroke diagnosis who participated in the National Health Survey (PNS) 2019. Among individuals who reported having had a stroke diagnosis (n=1975), the prevalence of stroke in young adults was 38.3% (n=695), predominantly in women (62%), without health insurance (83.1%), and residing in the Southeast (41.3%) and Northeast (28.7%) regions. Regarding disability, 42.7% of young adults reported some form of limitation in performing daily activities. Overall, the most prevalent risk factors among young adults were: high blood pressure (60.6%) and low adherence to protective factors, where 66.8% reported not following a proper diet and 73.3% did not engage in regular physical activity of 150 minutes per week. In the comparison by region, risk factors such as depression, inadequate diet, and alcoholism showed distinctions, with the Southeast region, which has the highest prevalence of stroke in young people, also significantly concentrating the highest rates of inadequate diet and alcoholism. The prevalence of stroke in young adults in Brazil at 38.3% is high, considering the global prevalence of 22% among people aged 15 to 49, and it is more pronounced in brown-skinned women with intermediate education, without health insurance, and residing in the Southeast and Northeast regions of the country. Most young adults who reported stroke live with high blood pressure (HBP) and inadequate diet and physical activity levels, habits that may be directly related to the lifestyle of these individuals. Therefore, primary and secondary prevention measures, addressing the control of exposure to risk factors, particularly in women in this age group, and longitudinal monitoring and management of stroke incidence, should be intensified.