Stroke prevalence is increasing, particularly among younger adults, according to a recent report from the Centers for Disease Control and Prevention (CDC). This concerning trend highlights an urgent need to understand why strokes are becoming more common and what can be done to reverse this trajectory. A stroke neurologist, Dr. Joshua Willey from NewYork-Presbyterian/Columbia University Irving Medical Center, sheds light on this critical health issue.
The Alarming Rise of Strokes: A Closer Look at the Data
The CDC report compared stroke data from 2011-13 to 2020-22 and revealed an overall 8% increase in stroke prevalence. More alarmingly, significant increases were observed in younger age groups: 14.6% for individuals aged 18 to 44 and 15.7% for those between 45 and 64. While stroke remains most prevalent in older adults (65 and older), the incidence in this group has thankfully not risen, making the surge in younger populations particularly concerning.
“The steep increase in rates among younger individuals is a significant concern,” emphasizes Dr. Willey. This rise suggests that factors affecting younger populations are driving the overall increase in stroke cases.
Unpacking the Reasons: Why Strokes Are Becoming More Common
Several interconnected health problems are contributing to the rising stroke rates in younger people. Dr. Willey points to key factors highlighted in the CDC report and corroborated by other studies:
Lifestyle Factors: Obesity, Inactivity, Diabetes, and High Blood Pressure
“A rise in obesity, physical inactivity, diabetes, and high blood pressure in younger people is translating into earlier cardiovascular disease and, consequently, an elevated risk of stroke at a younger age,” Dr. Willey explains. These conditions, often linked to lifestyle choices, are becoming increasingly prevalent in younger populations.
- Obesity: Higher rates of obesity contribute to various cardiovascular risks, including high blood pressure and diabetes, both major stroke risk factors.
- Physical Inactivity: Sedentary lifestyles reduce cardiovascular health, increasing susceptibility to stroke.
- Diabetes: Diabetes damages blood vessels and increases the risk of blood clots, significantly elevating stroke risk.
- High Blood Pressure (Hypertension): Hypertension is a leading cause of stroke. Dr. Willey notes, “It has been estimated that treating high blood pressure could prevent 50% of strokes in the U.S.” The increasing prevalence of hypertension in younger adults is therefore a critical concern.
The Opioid Epidemic: A Contributing Factor
Beyond traditional cardiovascular risk factors, the opioid overdose epidemic may also play a role in rising stroke rates among younger individuals. Dr. Willey mentions, “The increase in intravenous (IV) opioid use is linked to infections in heart valves, which can cause strokes.” Infective endocarditis, an infection of the heart valves, is a known complication of IV drug use and can lead to embolic strokes as infected clots break off and travel to the brain.
Recognizing Stroke: Symptoms in Younger and Older Adults
The signs and symptoms of stroke are generally consistent across all age groups. However, in younger people, stroke symptoms can sometimes be misdiagnosed or attributed to less serious conditions. Dr. Willey clarifies, “The symptoms of stroke in both younger and older patients tend to be similar… Since stroke tends to be less common in those who are younger, symptoms could be mistaken for a migraine, pinched nerves, or multiple sclerosis.”
It is crucial to recognize stroke symptoms promptly, regardless of age. A helpful acronym to remember the key signs of stroke is BE FAST:
- Balance: Sudden loss of balance or coordination.
- Eyes: Sudden vision changes, double vision, or loss of vision.
- Face: Facial drooping or uneven smile.
- Arm: Weakness or numbness in one arm.
- Speech: Slurred speech or difficulty speaking or understanding.
- Time: Time to call emergency services immediately (911 in the US).
Even if symptoms are brief or transient, it is essential to seek immediate medical attention, as these could be warning signs of an impending major stroke.
Dr. Joshua Willey, Stroke Neurologist, Explains Rising Stroke Rates in Younger Adults
Types of Strokes: Ischemic and Hemorrhagic
Strokes are broadly categorized into two main types: ischemic and hemorrhagic, each with different underlying mechanisms and implications.
- Ischemic Stroke: This is the most common type, accounting for about 80% of strokes in the US. Dr. Willey describes it as “like a blocked pipe.” Ischemic strokes occur when a blood vessel supplying the brain becomes blocked, often by a blood clot. This blockage deprives brain tissue of oxygen and nutrients, leading to cell damage and death.
- Hemorrhagic Stroke: Hemorrhagic strokes occur when a blood vessel in the brain ruptures and bleeds. “Hemorrhagic stroke is when the arteries burst,” explains Dr. Willey. This type of stroke is often more severe and has a higher fatality rate than ischemic stroke. Risk factors for hemorrhagic stroke include uncontrolled high blood pressure and certain social determinants of health. Hemorrhagic strokes often present with a sudden, severe headache and impaired consciousness.
While the overall proportion of ischemic and hemorrhagic strokes remains relatively consistent across age groups, certain populations, such as pregnant women, may have a higher risk of hemorrhagic stroke.
Prevention is Key: Reducing Your Stroke Risk
Adopting a proactive approach to health and lifestyle is crucial in mitigating stroke risk, particularly as rates rise in younger populations. The American Heart Association’s (AHA) Life’s Essential 8 provides a comprehensive framework for reducing the risk of stroke and promoting overall cardiovascular health. These essential measures include:
Life’s Essential 8 for Stroke Prevention
- Eat Better: Emphasize a diet rich in fruits, vegetables, and whole grains, such as the Mediterranean diet. Reduce intake of processed foods, fried foods, and foods high in saturated and unhealthy fats. For individuals with diabetes, choosing foods with a lower glycemic index is beneficial.
- Be More Active: Aim for at least 30 minutes of moderate-intensity exercise daily. Regular physical activity improves cardiovascular health and helps maintain a healthy weight.
- Quit Tobacco: Smoking significantly increases stroke risk. Quitting tobacco in any form is one of the most impactful steps to reduce stroke risk.
- Get Healthy Sleep: Aim for 7-9 hours of quality sleep per night. Adequate sleep is essential for overall health and cardiovascular well-being.
- Manage Weight: Maintain a healthy body weight with a body mass index (BMI) between 18 and 25. Losing even a small amount of weight if overweight or obese can significantly reduce stroke risk.
- Control Cholesterol: Manage cholesterol levels through diet, exercise, and medication if necessary. High cholesterol contributes to the buildup of plaque in arteries, increasing stroke risk.
- Manage Blood Sugar: Control blood sugar levels, especially for individuals with diabetes. Effective diabetes management is crucial in reducing stroke risk. Newer diabetes medications and monitoring technologies are aiding in better blood sugar control.
- Manage Blood Pressure: Maintain healthy blood pressure levels. Current guidelines recommend keeping blood pressure below 120/80 mmHg. Regular blood pressure monitoring and management are vital for stroke prevention.
Furthermore, access to healthcare and culturally tailored prevention programs are essential, particularly for addressing healthcare disparities and reaching underserved communities. Dr. Willey emphasizes the importance of “culturally tailored programs and meeting people where they are…to inform what the stroke signs and symptoms are, increase screening, and improve management of different health conditions, like high blood pressure.”
By understanding the reasons behind the rising stroke rates and taking proactive steps to manage risk factors and adopt healthy lifestyle habits, individuals, especially younger adults, can significantly reduce their risk of stroke and safeguard their long-term health. Consulting healthcare professionals for personalized advice and regular check-ups remains paramount in stroke prevention and overall well-being.
