Stroke under age 45: the rates are rising

Only 10 percent of people who experience a stroke are younger than 45, but the rate at which stroke occurs in younger people is on the rise. A study published in the Journal of the American Heart Association found that between 2000 and 2010, hospitalizations for ischemic stroke—the most common type—dropped 20 percent across all age ranges – good news, right? But among those aged 25–45, the rate rose 44 percent. What might be causing occurrences of the most common type of stroke to rise in younger people?

Younger people are less likely to get screened for stroke risk factors

Some of the same factors which put older people at risk of stroke, also increase stroke risk in young people: hypertension, high cholesterol, diabetes, and smoking. But it turns out that, according to studies, younger people do not get themselves screened for health issues as often, putting off tests for cholesterol, blood pressure, and blood sugar, for example, because they believe that they don’t need to be done until they’re older.

“Older adults expect to have these kind of issues, so they get screened. But someone in her twenties usually doesn’t think about something like blood pressure unless there’s a problem. She might only go to the doctor when she’s sick, and if she doesn’t get sick, she doesn’t get screened,” says Dr. Koto Ishida, stroke neurologist and Director of NYU Langone’s Comprehensive Stroke Center

Stroke incidence is decreasing overall

Overall, we know that mortality rates from strokes have significantly decreased over the past 50 years due to multiple factors, including better treatment for hypertension and increased use of aspirin. In addition, a study published in the Journal of American Medicine noted that the overall incidence of stroke in those over 65 years decreased by approximately 40% over the last 2 decades.

Doctors theorize that this is because the risk factors for stroke have become more well known, disseminated throughout society, and acted on by those who recognize the risks in themselves. So, the same risk factors that are increasing in young people—like cholesterol and blood pressure—are typically being better managed by those over age 50.

Younger people often don’t recognize the signs and symptoms of stroke

In addition to not getting screened as often for common stroke risk factors, studies also show that younger people may not recognize the signs of stroke when they happen, or are quick to attribute them to something other than stroke. According to the Mayo Clinic, signs that an individual of any age is having a stroke include:

• Trouble with speaking and understanding
• Numbness of the face, arm or leg
• Trouble with seeing in one or both eyes
• Severe headache
• Trouble with walking

However, if you think you’re too young for stroke, you might shake off these signs, because we’ve all had, for example, numbness from sleeping in a funny position, or sitting on a leg wrong, or stress headaches, or a momentary “brain fry” or two. In addition, stroke in older adults tends to impact the larger blood vessels, making them more likely to have the “big” stroke symptoms like facial drooping and incomprehensible speech–and therefore its easier to make the leap that a stroke may be happening.

In fact, a national survey conducted by Ronald Reagan UCLA Medical Center asked people what they would likely do within the first three hours of experiencing weakness, numbness, difficulty speaking or difficulty seeing–all common symptoms of a stroke. Among those under age 45, only a third said they would be very likely to go to the hospital, and 73 percent said they would likely wait to see if their symptoms improved!

Awareness is key to reducing the effects of stroke at any age

Timely treatment for stroke is critical. There is a very limited window in which to start treatment because the brain is very sensitive to lack of blood flow or to bleeding. So it’s important to know the risk factors, as well as the signs of stroke at any age.

As with anything, you are advised to check with your own healthcare professional about all medical matters, but in general, it’s recommended that everyone get regular wellness checks, even if you think you’re too young and healthy. In addition, consider good habits such as eating a healthy diet with plenty of fruits and vegetables, staying physically active, maintaining a healthy weight, and not smoking. And most of all, don’t think that strokes are just for older people.

References

• American Heart Association (March 2010). Stroke incidence rising among younger adults, decreasing among elderly, ScienceDaily, 1 March 2010.
• Wallace, J. B. (2016, May 11). Researchers document troubling rise in strokes in young adults, starting at age 25, The Washington Post, 11 May 2016.
• Naqvi, Jia (2017, April 15). Stroke rates appear to be rising steadily in young adults, The Washington Post, 15 April 2017.
• Fang, Margaret C. et al. (July 2014). Trends in Stroke Rates, Risk, and Outcomes in the United States, 1988 to 2008, The American Journal of Medicine, Volume 127, Issue 7, 608 – 615.
• Stanford University Health (n.d.). Stroke In Young People FAQs. Stanford University Health Care Online.
• Mayo Clinic (2018). Stroke Overview. Rochester, Minnesota: The Mayo Clinic Online.
• UCLA Health (2108). Survey Finds Most Young People Experiencing The Signs Of A Stroke Would Put Off Going To The E.R. , Ronald Reagan UCLA Medical Center Online, 2018.