Young Adults With Prediabetes Triple Their Risk of Stroke by Using Tobacco

Young adults with prediabetes who persistently use tobacco have triple the risk of stroke, even if they have no other cardiovascular risk factors, according to a preliminary study to be presented at the American Heart Association’s Scientific Sessions 2023, November 11-13 in Philadelphia, Pennsylvania.

In this study, investigators used the National Inpatient Sample, a large national database, to analyze 2019 US hospital admissions for over 1 million young tobacco users between the ages of 18 and 44. Patients in the population of interest were considered metabolically healthy, with no known cardiovascular disease risk factors, such as high blood pressure, type 2 diabetes, high cholesterol, or obesity. The study subjects were all long-term or persistent tobacco users. The researchers noted that of those admitted to the hospital, approximately 2 in 1000 patients had prediabetes and were dependent on tobacco use.

Two Dangerous Risk Factors

After comparing hospitalized tobacco users with prediabetes with those without prediabetes, researchers found that prediabetic patients had:

• Higher rates of chronic obstructive pulmonary disease (19.2% vs 11.7%, respectively), previous heart attack (1.5% vs 0.4%, respectively), and chronic kidney disease (2.5% vs 0.9%, respectively)
• Greater odds of heart attack, stroke, or heart failure (2.9% vs 1.4%, respectively)
• A higher chance that the hospitalization was due to a stroke (1.9% vs 0.5%, respectively)

After adjusting for factors such as age, race, sex, and alcohol/drug abuse, the analysis showed that hospitalized tobacco users with prediabetes had a 3.31-times higher risk that the hospitalization was due to stroke.

“These findings from a large-scale US study warrant early screening and prevention strategies for prediabetes in young tobacco users in order to curtail their risk of stroke,” said study author Advait Vasavada, MBBS, a resident in family medicine at the University of Nebraska Medical Center in Omaha.

“If you’re a metabolically healthy young adult dependent on tobacco use, it is wise to cut down on [or] better yet eliminate tobacco use completely. It is also worth noting that having prediabetes can significantly increase your risk of having a stroke at a young age, even if you don’t use tobacco products,” Vasavada said. “Developing an overall healthy lifestyle, plus ensuring that your blood sugar is well controlled and measured in your routine preventive care visits, are advisable.”