Down Syndrome associated with high risk of stroke

Assoc Professor Srikanth 

People with Down Syndrome are at significantly higher risk of stroke compared to the wider population, according to multi-disciplinary research undertaken at Monash University.

Improved medical care over the last 50 years has markedly increased life expectancy in people with Down Syndrome from around twelve years to approximately 60 years. With increased survival into late adulthood, there is now a greater recognition for the prevention and treatment of ageing-related diseases in people with Down Syndrome.

The collaborative research study led by Professor Chris Sobey, Head of Cardiovascular Disease Program, Biomedicine Discovery Institute and Associate Professor Velandai Srikanth, Head of Strokeand Ageing Research, provides the first estimates of the risk of stroke and heart attacks in people with Down Syndrome at a population-level.

“We found that people with Down Syndrome have a three-fold increase in the risk of stroke compared with the wider population without Down Syndrome,” said Professor Sobey.

“Interestingly, this increased stroke risk is greater in women and among those aged over 50.”

Published last week in PLOS One, the study analysed hospitalisation data from 4000 adults with Down Syndrome, comparing them with 16,000 age-matched adults without Down Syndrome.

“Our analysis suggests that ischaemic stroke (caused by blockage of a brain artery) in people with Down Syndrome may occur because of a blood clot arising from the heart,” said Associate Professor Srikanth.

“People with Down Syndrome are prone to heart structural problems at birth, and it is possible that these problems may predispose them to clots travelling up from the heart to block an artery in the brain.”

Associate Professor Srikanth is keen to note that this theory requires confirmation by further research.

 “Surprisingly, our study also found that men (but not women) with Down Syndrome have a lower risk of heart attacks compared with the general population,” added Associate Professor Srikanth.

“The lower risk of heart attacks in males is difficult to explain with our data alone, and therefore raises some interesting avenues for further translational research both in the clinical arena and in the basic laboratory.”

 “Before we started this research, we were surprised to find little or no information existed about the risk of disease in people with Down Syndrome,” said Professor Sobey from the Monash Biomedicine Discovery Institute.

“We chose to collaborate with clinical researchers at the Monash Health Translation Precinct in order to translate our theories previously raised in mouse models.”

“Our results will raise the awareness of the risk of stroke in people with Down Syndrome, and encourage further study of the reasons underlying this increased risk,” added Professor Sobey.

This study also highlights the potential of translational research at the Monash Partners NHMRC Advanced Health Research and Translational Centre.