Stroke: A young person’s disease?

If you think you’re too young to have a stroke, think again. A study published in April 2017 showed that the rate of stroke among young people has risen dramatically in the past 15 years. The data didn’t surprise me at all. I’ve witnessed this trend firsthand in Washington, D.C.

Most people think of stroke as something that strikes older adults, but the study showed that between 2003 and 2012, stroke rates increased nearly 42 percent among men ages 35 to 44, and 30 percent for women in that age group.

A recent study shows that #stroke rates are increasing in younger adults – up to 42% in men ages 35-44 since 2003.

I’d say the average age of our patients is 40 to 60. When you compare this with our National Institutes of Health extramural stroke program partner Suburban Hospital in nearby Bethesda, Md., you can see where demographics and overall health comes into play. The average age of their stroke patients is 70 to 90.

The Bethesda community is primarily made up of white residents who have fewer health complications. D.C. has a larger population of African-Americans, who are at greater stroke risk overall, and more people with stroke risks such as obesity and high blood pressure.

Let’s take a closer look at why younger adults are at greater risk for stroke than ever before, and what you, health professionals and the community at large can do to turn this trend around.

Why stroke risk has increased in younger people

Stroke risks fall mainly into two levels: non-modifiable risks, which you have no control over, and modifiable risks, which are within your control to manage and treat.

Non-modifiable risk factors include:

  • Age: Your risk of stroke nearly doubles every 10 years after the age of 55.
  • Gender: Men have a higher stroke risk than women.
  • Race and ethnicity: The risk for stroke is two times higher for African-Americans and 1.5 times higher for Hispanics than for whites.
  • Family history: If a grandparent, parent or sibling has had a stroke, particularly before the age of 65, you may be more at risk.

Modifiable risk factors include:

It’s these modifiable risks that are the primary reason stroke rates for younger adults are rising. The 2017 study found that the number of men and women between age 18 and 64 with these conditions increased across the board, as did the prevalence of having three or more of these risk factors. 

The danger of overlooking stroke symptoms

While not a true risk factor, younger adults often face another danger: their feeling of invincibility. Young adults tend to overlook the signs of a stroke. They think they’re too young and what’s happening couldn’t possibly be a stroke. This can lead to a delay in treatment, and in a condition where seconds matter, this can be devastating to survival and recovery.

The gold standard for treating ischemic strokes is tissue plasminogen activator (tPA), a clot-busting drug. However, tPA must be given within four and a half hours of the onset of stroke to work effectively. Younger people, if treated in a timely manner, often have a better chance of recovery because their brains have greater plasticity. The surviving cells take over for those that are killed off by the stroke. We lose some of that regeneration as we age.

Rehabilitation also can be impeded by the presence of health problems such as diabetes, high blood pressure or cholesterol.

Stroke is the fifth leading cause of death in the United States, and the leading cause of disability. It costs the country $33 billion a year in healthcare services, medicines and missed days of work. When someone has a stroke during their most productive years, it can cost even more – not just in money but in quality of life as they may require more years of care and missed work.

Know the signs of stroke and never think you’re too young to have one. Use the acronym FAST to quickly identify common stroke symptoms:

  • Face: Can you smile? An inability to smile or a one-sided expression can indicate a stroke.
  • Arms: Can you raise both arms? One-sided muscle weakness or paralysis can indicate a stroke.
  • Speech: Can you say a simple sentence? Slurred speech or difficulty speaking are signs of a stroke.
  • Time: Call 911 immediately if you notice these symptoms.

Other signs to be aware of include:

  • Sudden vision trouble in one or both eyes
  • Sudden severe headache with no known cause
  • Sudden confusion or trouble understanding
  • Sudden trouble walking, dizziness or loss of balance or coordination

How young adults can reduce risk factors for stroke

As with any health condition, prevention is the best medicine, and stroke is no different. Fortunately, many stroke risks can be prevented, managed or treated if they appear.

A good start to reduce your risk of stroke is to develop a healthy lifestyle:

  • Eat a healthy diet.
  • Stay physically active.
  • Don’t smoke. Ask for help to stop smoking.

One in three adults in the U.S. have high blood pressure, but only about half have it under control. And many younger adults don’t even know they have it. See your doctor for an annual exam, and if it’s discovered that your blood pressure is high, follow recommendations to lower it.

If you’ve been diagnosed with diabetes, monitor your blood sugar and use medicine, diet and exercise to keep it within the recommended range. One in three people have prediabetes, a condition in which blood glucose levels are higher than normal. Talk with your doctor about how to prevent or delay the onset of diabetes.

There are also steps we can take as a community to lower stroke risk. One is to continue and expand nutritional programs, especially in our schools. We want our children to learn healthy eating habits early in life. It should be a given that any meal served in our schools is a healthy one.

We also must work together to address food deserts, those neighborhoods in which there is a lack of fresh fruit and vegetables and other healthy foods. These areas lack grocery stores and farmers’ markets, so people can’t buy healthy foods to make at home. Vending machines in our public spaces and workplaces often offer few healthy choices, so we can work to improve the available options.

Exercise does wonders for our health. It lowers weight, stress, blood pressure, blood sugar and cholesterol. We must create opportunities to promote physical activity and access to suitable spaces – indoors and out.

This trend of younger people having strokes is alarming, but it’s reversible. With hard work from younger adults, health professionals and the community, we can better manage those modifiable risk factors and reduce our risk of stroke.

Associate Medical Director, Comprehensive Stroke Center, MedStar Washington Hospital Center

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