According to CNN, researchers have found that the rate of stroke among young people rose from 33.9 cases per 100,000 people in 1993–1994 to 62.2 cases per 100,000 people in 2020. The study also reported a slight increase in the number of people surviving after a stroke; a finding that suggests more young people may be living with the long-term consequences of stroke.
Dr. David Robinson, the lead author of this study published in the medical journal Neurology, says: “Stroke is a devastating disease at any age, but when it occurs in younger people it is far more devastating.”
Robinson, an assistant professor of clinical neurology and rehabilitation medicine at the University of Cincinnati College of Medicine, adds: “Disability from stroke can make performing essential life tasks such as employment or caring for young children much more difficult. So knowing that stroke does not only happen to older adults and may affect younger people too, and that there are ways to try to prevent it, are among the most important points to remember from this study.”
The increase in strokes is mainly related to blood clots caused by blocked arteries
This study examined stroke cases among residents aged 20 to 54 in northern Kentucky. From 1993 to 2020, 2,076 first-time strokes were recorded in this population. Of these, 738 cases, equal to 35.6 percent, were among Black individuals and 1,030 cases, equal to 49.6 percent, were among women.
According to the research, the main driver of the increase was ischemic strokes-the most common type of stroke that occurs when blood flow to part of the brain is blocked due to arterial occlusion.
Researchers also observed that over this 27-year period the prevalence of some risk factors among stroke patients increased. Hypertension rose from 47 to 60 percent, diabetes from 19 to 26 percent, atrial fibrillation (a type of heart rhythm disorder) from 1 to 6 percent, and substance use from 5 to 40 percent. The latter increase was mainly attributed to greater marijuana use.
However, because comparable data from people without a history of stroke were not available, the study authors cannot determine whether these changes in risk factors caused the increase in stroke rates. In addition, the same trends were seen among older people, but stroke rates in that group did not rise.
Dr. Robinson said: “These factors may be part of the story, but I don’t think they explain the whole thing,” and added that increases in issues such as obesity and high cholesterol and a sedentary lifestyle may also play a role in stroke risk. “To know how we can intervene and reduce this trend, I think we should start with what we know better: reducing cardiovascular risk factors.”
He pointed to the American Heart Association’s eight essentials for health, including healthy diet, exercise, avoiding tobacco, quality sleep and control of weight, cholesterol, blood pressure and blood sugar, and added that it is important for young people to check these markers regularly, because if risk factors are detected early, there is likely the best opportunity to intervene and reduce adverse outcomes.
Dr. Christopher Anderson, an associate professor of neurology at Harvard Medical School, who was not involved in the study, says: “The important point is that a marked increase in stroke rates was observed in a population that, in terms of racial background, socioeconomic status and education level, largely represents the U.S. population. Therefore the results are more likely to be generalizable nationwide.”
Dr. Michelle Leppert, a vascular neurologist at Tufts Medical Center, also said she was not surprised by the findings. Not involved in the study, she emphasized the importance of studies like this to collect data about this age group and added: “The raw number of cases is still not very large. But we need to spend time and resources understanding this issue, because it is not something that will go away on its own. Its situation is not improving.”
She added that stroke in young people remains a relatively rare event and young people need not panic. Nevertheless, visiting a doctor for an annual checkup is important so that people who may be at risk can be identified. Physicians should also be aware of the increase in stroke among younger people so they can detect and treat vascular risk factors at an early stage.
According to Leppert, young women, in whom stroke is more common than in young men, should closely monitor their blood pressure during pregnancy and postpartum. Also, if they experience migraine with visual changes while taking estrogen-containing contraceptive pills, they should talk to their doctor.
Anderson wrote in an email: “Young adults should know that high stress, unhealthy diet, lack of sleep and a sedentary lifestyle, even in early and mid-adulthood, have a real and measurable impact on the risk of conditions such as stroke, and unfortunately this accumulated risk is not going to wait until retirement age to have a serious effect on a person’s health.”