Stroke Increasing Among Youth: What Are the Key Steps to Reduce Risk?

- Most people do not think about cardiovascular health until they get older, but a recent study revealed that strokes, which are one type of cardiovascular disease, are increasing among young people, having nearly doubled over the past three decades. Dr. David Robinson, the lead researcher of the study published in the medical journal Neurology, stated, "Stroke is a devastating disease at any age, but it is particularly devastating when it strikes young people."

Researchers found that the stroke rate among young people rose from 33.9 cases per 100,000 individuals between 1993 and 1994 to 62.2 cases per 100,000 individuals in 2020. The study also recorded a slight increase in the number of stroke survivors, indicating that more young people may be living with its long-term effects.

Robinson, an assistant professor of clinical neurology and rehabilitation medicine at the University of Cincinnati College of Medicine, explained that the disability resulting from a stroke can make it difficult to perform daily activities, such as working or caring for young children. He added that awareness of the possibility of having a stroke at a young age, and knowing that there are ways to prevent it, is important.

Experts advise young people to learn how to protect their cardiovascular health and reduce the risk of stroke. Ischemic strokes behind the increase The study examined strokes among individuals aged 20 to 54 in the Greater Cincinnati area and Northern Kentucky.

Between 1993 and 2020, 2,076 first-time strokes were recorded, including 738 cases among Black individuals (35.6%) and 1,030 cases among women (49.6%). The study indicated that ischemic strokes, which are the most common type, were the main cause of this increase, occurring when blood flow to a part of the brain is interrupted.

Researchers observed an increase in stroke risk factors during the 27-year study period, with hypertension rates rising from 47% to 60%, diabetes from 19% to 26%, atrial fibrillation from 1% to 6%, and substance use from 5% to 40%, largely attributed to increased marijuana use. However, due to the lack of similar data for individuals who did not suffer a stroke, researchers cannot determine whether these changes in risk factors explain the rising stroke rates.

Although these trends were also observed among older adults, stroke rates among them did not increase. Robinson stated, "This may be part of the explanation, but it does not explain the whole thing," adding that rising rates of obesity and cholesterol, along with decreased physical activity, may also increase the risk of stroke.

Robinson explained, "I believe there are several factors that come together, not just one. To reduce this risk, we should start with what we know well, which is reducing cardiovascular disease risk factors."

Robinson pointed to the "eight essentials" from the American Heart Association, a list that helps reduce risk factors, including following a healthy diet, engaging in physical activity, avoiding tobacco, getting good sleep, and managing weight, cholesterol, blood pressure, and blood sugar. He added that it is important for young people to have a primary care physician who monitors their condition and regularly checks these indicators, noting that it is crucial to start caring about cardiovascular health at an early age, as early detection of risk factors gives us a greater opportunity for intervention and reducing complications.

Dr. Christopher Anderson, head of the stroke department in the neurology division at Mass General Brigham in Boston, stated that the results were not surprising but aligned with trends indicated by previous studies. Anderson, who is also an associate professor of neurology at Harvard Medical School, pointed out that the significance of the study lies in the substantial increase in stroke rates observed among a group of individuals characterized by racial, social, economic, and educational traits that largely represent the U.S. population, making it likely that the results can be generalized to the country.

Dr. Michelle Libert, a neurologist specializing in vascular diseases at Tufts Medical Center, stated that the results did not surprise her either, emphasizing the importance of conducting studies that gather data on strokes among young people. Libert, who is also an associate professor of neurology at Tufts University School of Medicine, explained that "the actual numbers are still relatively low, but we should start investing time and money to understand this issue, as it will not disappear and does not seem to be improving."]

She added that strokes are still relatively rare cases, so there is no need for panic among young people. However, she stressed the importance of annual health check-ups with a doctor to identify those at higher risk, along with raising awareness among doctors about the increasing rates of strokes among young people and working to identify and treat the associated vascular risk factors early.

Libert pointed out that young women who suffer strokes at a higher rate than young men should closely monitor their blood pressure during pregnancy and after childbirth, and consult a doctor if they experience migraine attacks accompanied by visual changes while using estrogen-containing contraceptive pills. Anderson stated in an email: "Young people should be aware that severe stress, an unhealthy diet, lack of sleep, and insufficient physical activity, even in early and middle stages of life, significantly and measurably affect the risk of diseases such as stroke."]

Unfortunately, one does not have to wait until retirement age for these accumulated risks to significantly impact human health.