Gene Variants Found to Raise Stroke Risk in Younger Women

Finding could lead to test to spot variants in high-risk women

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By Angela Parisi
HealthDay Reporter

FRIDAY, Aug. 4, 2006 (HealthDay News) -- Scientists have homed in on some gene variations that may one day help to identify younger women at a higher risk of stroke.

While stroke risk usually increases with advancing age, certain versions of a gene may raise the chances of early stroke in women, the researchers said.

The new findings emerge from data collected for the "Stroke Prevention in Young Women Study 2," which is examining genetic risk factors for ischemic stroke in young women. Ischemic strokes account for about 83 percent of all strokes; they are caused by a blockage within a blood vessel supplying blood to the brain.

The University of Maryland researchers examined the phosphodietsterase 4D (PDE4D) gene, which previous studies had linked to stroke risk in different populations, such as the elderly. But, the Maryland researchers narrowed their focus to the genetic variations in more than 400 black and white women, ages 15 to 49, half of whom had suffered an ischemic stroke.

The study found an increased risk, ranging from 50 percent to 100 percent, depending on the particular genetic variation. And, the increased risk was similar for both black and white stroke patients.

"Stroke is not common in young women, but we know it occurs and is often heralded by worsening migraine with aura, smoking, or the beginning of birth control pills in women who have migraine with aura," said Dr. Christy Jackson, associate clinical professor of neurosciences at the University of California, San Diego, Women's Cardiovascular Health Program.

The study was published in the August issue of the journal Human Molecular Genetics.

The new findings add to a growing body of research that points to the potential role of genetics on stroke risk. "Until three years ago, no one even knew that this stroke gene existed", says Dr. John W. Cole, a research staff physician at the Baltimore Veterans Affairs Medical Center and an assistant professor of neurology at the University of Maryland School of Medicine.

In 2003, Icelandic researchers first identified the stroke gene. Cole and his colleagues basically replicated the European findings and pinpointed the gene variations affecting a young, female, and biracial population. Many past U.S. studies have looked at older, Caucasian groups.

The new findings may eventually lead to screening for stroke genes in high-risk women. And they could lead to counseling on lifestyle changes for women who test positive for the gene, Cole said.

Finding the stroke gene variants in a woman won't be a death knell, but could serve as a warning bell. Just as a positive allergy test for seafood would suggest you steer clear of sushi, a stroke gene test might indicate it's a good idea to drop some weight, stop smoking, or improve your diet, Cole said.

"Everyone has this gene and roughly the same layout, just like everyone has a closet full of clothes, but they're different clothes. The same kind of variation exists in genes," Cole said.

This study shows that if you're a premenopausal woman who has this gene variation and smokes, you have a powerful reason to quit. The combination of the gene variant and smoking increases your risk of stroke further than either factor alone, he explained.

"We already knew that smoking was bad. Now we know that this gene variant could play a role in mediating that risk," Cole said.

Jackson added: "This study illustrates one mechanism by which smoking increases a young woman's risk of stroke in ways in which we hypothesized, but had not proven. This helps us to encourage smoking cessation in young women."

Smoking aside, Cole said there are many risk factors that affect the chance of stroke, and certain genes -- coupled with other risks -- ultimately determine your risk.

There's not much you can do to change your genes, but you can modify other risk factors, he said.

"We know that there are standard risk factors for stroke, such as smoking, high blood pressure, obesity, diabetes, and high cholesterol. We want both patients and physicians to stay focused on addressing those factors," he said.

More information

For more information about stroke risk for women, visit the National Women's Health Information Center.

SOURCES: John W. Cole, M.D., research staff physician at the Baltimore Veterans Affairs Medical Center, and assistant professor of neurology, University of Maryland School of Medicine, Baltimore; Christy Jackson, M.D., associate clinical professor of neurosciences, University of California, San Diego, Women's Cardiovascular Health Program; August 2006, Human Molecular Genetics

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