Often considered a disease of the older population, recent reports are indicating that an estimated 10% of stroke victims are less than 50 years of age and, according to a recent study published in the Journal of the American Medical Association (JAMA), ischemic stroke rates have risen in young adults aged between 24-50 years. The study further points out that hospitalization rates for stroke have also increased for both women and men—nearly double in the case of men.
Research conducted by Dr. Mary George, and her team at the CDC, indicate though mortality rates due to stroke have decreased substantially over the past 20 years, this decrease was primarily seen in patients older than 50 years and was attributable to reductions in blood pressure, decreased smoking rates, reduced intake of salt and processed foods coupled with increased activity levels along with earlier detection and tracking of hypertension by clinicians in this population. However, the same study showed in younger adults– people aged 35- 44 years–the prevalence for stroke rose by nearly 42%! Risk factors for this increase included obesity, hypertension, dyslipidemia, tobacco use and diabetes.
In addition to these risk factors and an increasingly sedentary lifestyle by younger adults, awareness of the disease by both patients and their HCPs is also crucial. Oftentimes, stroke symptoms may go unnoticed by young adults and are not reported to their doctors. Young people are less aware of their blood pressure and stroke in young adults may present differently as ischemic stroke rather than the hemorrhagic or ‘bleeding’ events most commonly associated with the disease. Furthermore, patients — and many doctors — do not think of ‘stroke’ when a young adult presents with less obvious symptoms of the disease, such as sudden unsteadiness, headache or weakness in the face.
Why is this clinically relevant?
- Rates for ischemic stroke rising amongst younger adults aged 35-45 years
- Rising rates of obesity and T2D coupled with increased sedentary lifestyle is more prevalent in this age group
- Obesity and T2D are risk factors for hypertension and could lead to increased risk for stroke in this population
- Symptoms of ischemic stroke often not noticed by patients or providers in younger population and include loss of balance, facial weakness or nausea
- Identification of at-risk patients and instituting appropriate nutritional and lifestyle interventions is important
- Clinicians should focus on prevention in younger adults by encouraging them to know their BP and to be aware of the less common symptoms associated with stroke
 George MG, Tong X, Bowman BA. Prevalence of Cardiovascular Risk Factors and Strokes in Younger Adults. JAMA Neurol. Published online April 10, 2017. doi:10.1001/jamaneurol.2017.0020