When you think about someone having a stroke—when blood flow to the brain is interrupted, either by a clot or a hemorrhage—you may imagine a person in their 60s, 70s or 80s. Your risk for stroke does increase as you age, but a stroke can happen to anyone, and increasingly, it’s happening to people younger than 55.
“In the past two decades, the rate of stroke in people under the age of 55 has increased, with some studies showing a 36 percent increase and some up to 67 percent,” says UNC Health vascular neurologist Kostika Mulo, DO. “At the same time, there’s been a decrease in stroke patients over the age of 55. That trend shows that we’ve done a good job preventing stroke in the elderly, but we’re not doing as well with younger populations.”
What’s driving this increase, and what can be done about it? Dr. Mulo offers five facts to know.
More young people now have chronic conditions that increase stroke risk.
Historically, when people younger than 55 had a stroke, it was due to a genetic factor or an autoimmune disorder, Dr. Mulo says.
“That’s shifted in the last few decades,” he says. “Now, younger people are developing those classic risk factors of high blood pressure and diabetes earlier, as well as the conditions that lead to those risk factors, like sleep apnea and obesity.”
Smoking (both cigarettes and vapes), heavy alcohol use and drug use also increase the risk for stroke.
For people who have strokes in their teens or 20s, it’s still likely due to genetics or a secondary medical condition. Those reasons can also cause stroke in your 30s, 40s and 50s, but what’s changed is that these middle-aged groups are more likely to have the typical risk factors now.
“In 80 percent of strokes under the age of 55, we find those typical risk factors,” Dr. Mulo says.
Certain groups are at higher risk.
Women have always had a higher risk for stroke because of the estrogen in their bodies, and like men, they’re developing stroke risk factors earlier these days.
Estrogen is associated with an increased risk of blood clots, which is why you’ll want to talk to your doctor about your individual stroke risk before choosing a hormonal contraception such as birth control pills, which contain estrogen, or before pursuing hormone therapy for menopause.
Pregnancy can raise your risk of stroke because blood pressure tends to rise in the second half of pregnancy and because pregnancy and the postpartum period naturally make your blood more likely to clot so that you don’t have excessive bleeding during delivery. Thanks to the other risk factors, “pregnancy-related strokes and strokes in the early postpartum period are on the rise,” Dr. Mulo says.
Women are more likely than men to have autoimmune conditions that increase stroke risk.
Black and Hispanic people are also developing high blood pressure and diabetes earlier, driving up their risk.
Younger people are less likely to think they’re having a stroke.
When it comes to strokes, you need to act fast—every moment that your brain goes without blood is damaging, and treatments for stroke must be administered within a certain timeframe from when your symptoms started.
“Younger people aren’t as educated on symptoms of a stroke, or they don’t think they could be having a stroke, so that tends to delay them getting to a hospital,” Dr. Mulo says. “If you’re older and have had more doctor’s visits, you tend to get educated on those signs and symptoms.”
Symptoms for a stroke are the same at any age and can be remembered with the phrase BE FAST.
B: Balance is off or hard to maintain.
E: Eyesight suddenly changes; you may have blurred or double vision.
F: Your face may droop or be numb on one side.
A: Arms (or legs) will feel weak or difficult to move.
S: Speech changes; you may slur words or not be able to understand someone else.
T: Time is of the essence; call an ambulance to take you to the emergency department.
“I remind people that stroke symptoms are really abrupt,” Dr. Mulo says. “One second, you’re fine and the next second you’re not. If you notice something abrupt, do something.”
Some parts of stroke recovery are easier for younger people, but it might be more difficult in the long run.
While younger people may delay getting to the hospital and getting treatment, which can make the immediate aftermath of a stroke seem more severe, parts of their recovery may be faster.
“A younger brain tends to recover better than an older brain,” Dr. Mulo says, because younger brains have more neuroplasticity, or ability to form or strengthen connections in the brain.
While younger stroke patients’ recovery and rehabilitation usually results in less physical disability than older people, having a stroke earlier in life means living with the long-term consequences of stroke for longer.
“There are chronic issues way past a stroke, like a higher risk of anxiety, depression, fatigue, brain fog and other cognitive challenges,” Dr. Mulo says. “It might mean more time out of work because of ongoing symptoms.”
Strokes are often preventable.
You can take steps now to prevent a stroke, no matter your age.
“Establish care with a primary care provider so that you can have regular blood work and screenings,” Dr. Mulo says. “Know your family history. If you have a strong family history of cardiovascular disease or stroke, it’s especially important to follow up on other risk factors.”
With regular visits to your primary care provider, you’ll know if metrics such as blood sugar, blood pressure or cholesterol are rising so that you can proactively address them with lifestyle changes and medications, rather than allowing damage to accumulate for years without knowing.
Your primary care provider can support you in the healthy habits that prevent stroke: regular exercise (aim for 150 minutes of movement a week), a healthy diet, quality sleep, quitting smoking, stress management and identifying medical conditions that could increase your risk for stroke.
Even if your overall risk seems low, continue to be alert to the possibility of a stroke.
“Know that this could happen to anybody,” Dr. Mulo says. “It shouldn’t keep you up at night, but it’s important to make positive lifestyle changes and know the symptoms so that you can call for help if something happens.”
Talk to your doctor about your risk for stroke. If you need a doctor, find one near you.The post 5 Things to Know About the Rise of Strokes in Young People first appeared on UNC Health Talk.
