Treating one condition nearly always seems to create the need to treat another, either at the time or later down the road. A new European report published this week the journal Neurology suggests a substantial risk of stroke in young adulthood among those who received growth hormone replacement as children.

The authors of the study investigated the occurrence of stroke and which types of stroke occurred in a large, population-based cohort of patients in France who received growth hormone to treat short stature in childhood. The results show a low risk increase for strokes caused by burst blood vessels in young adults treated as children, warranting that patients who received the growth hormone treatments should be counseled on this risk and its implications.

“This information should also be made available to those who misuse (growth hormone) for improving athletic performances, body building, and other questionable reasons,” the French and British researchers wrote in the report. The number of teens who report using human growth hormone to enhance performance is on the rise, according to recent estimates.

Growth hormone replacement therapy to treat children for pituitary gland deficiencies, increase height, and a variety of other conditions was first approved in the U.S. in the mid-1980s. Earlier research has suggested increased risk of death from heart and vascular diseases from the growth hormone treatment. However, little is known about the long-term effects of the therapy, according to the authors of the new report.

The current study found the link strongest for hemorrhagic stroke, which occurs when a blood vessel in the central nervous system bursts. Most strokes, when all causes are considered, tend to be ischemic in nature. These are caused by blood vessel blockages by clot formation. The study did not reveal why hemorrhagic stroke occurs more frequently in those with history of growth hormone treatment.

“What really needs to be remembered is that there was a small number events and that this was an association,” said Dr. Laurie Cohen, director of the Neuroendocrinology Program at Boston Children’s Hospital and who was not involved in the new study. “It doesn’t show that growth hormone causes strokes.”