ArticleFrontiers in neurology2026
The silent risk: cardiometabolic burden and etiology of young stroke in a South Asian migrant cohort, United Arab Emirates.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Young-adult stroke in the Arabian Gulf remains poorly characterized, despite a resident population dominated by South Asian labor migrants in whom cardiometabolic disease is often under-diagnosed. We therefore aimed to characterize the etiology and vascular risk-factor burden of young stroke in a single-center United Arab Emirates cohort, testing whether the recorded risk profile reflects true prevalence or diagnostic gaps. In this retrospective cohort study, we reviewed all patients aged 18-49 years with radiologically confirmed stroke admitted to a secondary-care hospital in Ras Al Khaimah between January 2020 and March 2026, applying adjudicated subtype classification, and used a pre-specified multivariable model to identify factors associated with ischemic presentation. Of 421 patients screened, 314 met criteria (mean age 41.0 years; 81.2% male; 65.6% South Asian). Objectively measured risk far exceeded documented history: only 49.0% had recorded hypertension, yet 74.5% had elevated admission blood pressure; dyslipidemia was documented in 15.9%, yet an abnormal lipid profile was found in 73.9% of those tested; and 29% of all diabetes was first diagnosed at the stroke admission. Small-vessel occlusion was the leading determined ischemic subtype, and diabetes was the only factor independently associated with ischemic stroke (adjusted OR 2.34, 95% CI 1.35-4.07). South Asian patients differed chiefly by sex and ischemic predominance rather than independent metabolic excess, indicating that ethnicity defined the exposed population while diabetes and hypertension were the operative mechanisms. We conclude that, in this workforce, the low recorded prevalence of vascular risk reflects widespread under-diagnosis, not low true prevalence-stroke was frequently the first presentation of unmanaged cardiometabolic disease, identifying accessible primary care and workplace screening as concrete prevention priorities.
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