Alarming rise in stroke rates among adults and children with sickle cell disease in the US (Image credit: iStock)
Stroke According to a recent study, mortality rates from sickle cell disease are increasing among both adults and children, despite new standards of care aimed at reducing this risk. People with sickle cell disease are particularly vulnerable to strokes, which occur when blood vessels in the brain rupture or become blocked, leading to potentially life-threatening complications.
Following a clinical trial in 1998, doctors began using regular red blood cell transfusions to reduce the risk of stroke in children with high-risk sickle cell disease. This approach initially showed promise, reducing incidents of stroke in children during the first two years. However, new research now indicates that the risk of stroke continues to increase as patients age, doubling every two decades of life.
The study, published in the journal Blood on September 20, reports that the overall risk of a cerebral hemorrhage The incidence of stroke increases 13-fold between the ages of 20 and 60 in people with sickle cell disease. Although there was an initial decline in stroke rates after the 1998 trial, the highest stroke rates across all age groups occurred in the 2010s.
“Even in children, who probably receive the best care for sickle cell disease in the U.S., these trends are going in the wrong direction,” said Dr. Ted Wun, principal investigator and associate dean for clinical and translational research at the University of California, Davis, School of Medicine.
Researchers analyzed data from emergency rooms and hospitals in California, and identified more than 7,600 patients with sickle cell disease. Nearly 10 percent of these patients suffered strokes over time. One of the key findings was that doctors may not be performing enough tests or interventions, such as regular brain ultrasounds, to assess stroke risk in sickle cell patients. In addition, some patients may not be receiving enough blood transfusions or consistent treatment with hydroxyurea, a drug that helps reduce the formation of sickle-shaped red blood cells.
Other factors that contribute to stroke risk among sickle cell patients include high blood pressure, high cholesterol, and transient blood clots that can temporarily block blood flow to the brain.
“Rising stroke rates highlight the importance of paying attention to screening for high cholesterol, high blood pressure and other risk factors in adults,” said Dr. Olubusola Oluwole, lead researcher and assistant professor at the University of Pittsburgh.
Dr. Wun further revealed that while pediatric care for sickle cell patients focuses on stroke prevention, less attention is paid to adult patients. He stressed that preventive measures known to reduce the risk of stroke in the general population are equally crucial for those with sickle cell disease.
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