Strokes in young people are increasing sharply

While strokes are becoming rarer in older people, the numbers are increasing in younger people. But why is a disease that has long been associated primarily with old age increasingly affecting people in the middle of their working lives?

Researchers at the University of Cincinnati in the USA investigated this question. They examined how strokes developed in people aged 20 to 54 over almost three years. In six study periods between 1993 and 2020, they recorded a total of 2,076 people who suffered a stroke for the first time. The study was published in the journal “Neurology”.

The result is clear: in 1994, the stroke rate among people under 54 was around 34 cases per 100,000 people. In 2020 there were almost twice as many, around 62 cases. For people aged 55 and over, however, the rate developed in the other direction: it fell from around 619 to 453 cases in the same period.

Ischemic strokes in particular increased among younger people. The blood supply to part of the brain is blocked. This rate increased from around 24 to 47 cases per 100,000 people per year. The researchers found no comparable increase in strokes caused by cerebral hemorrhage.

Part of the explanation could lie in known risk factors. High blood pressure, diabetes and atrial fibrillation increased among younger stroke patients. But drug consumption also increased: in 1994, 4.6 percent of those affected consumed drugs, and in 2020 it was 40.2 percent. Particularly common: marijuana use.

A recent review by researchers at the University of Oxford shows that this development can also be observed in other regions. The results were published in the specialist magazine “International Journal of Stroke”. Ahmad Nehme and Linxin Li evaluated international studies on strokes in people under 55 years of age. In 24 of 36 studies with data from after 2000, stroke rates increased among younger people.

What's behind the increase

Almost all studies showed that the numbers developed less favorably in younger age groups than in older ones. "Our studies show a threatening increase in strokes among young people - both in Oxfordshire and other high-income countries," Li is quoted as saying in a statement.

The Oxford researchers also see known vascular risks as an important part of the explanation: Obesity and diabetes have increased, and dangers such as high blood pressure often remain undetected at this age. But these factors do not seem to explain everything: in Oxfordshire, the rate of stroke among younger people also increased among people who did not have high blood pressure or diabetes and did not smoke.

The researchers therefore also point to increased psychological stress. In 18- to 49-year-olds, greater perceived stress was associated with a higher risk of strokes, the cause of which remained medically unclear - even after classic vascular risks were taken into account.

Whether stress, long working hours or the classic risk factors that have become more common are actually causing the increase cannot be determined from the data available so far. The studies initially show connections.

But one thing is clear: strokes don't just affect older people. This is precisely why high blood pressure, diabetes and other vascular risks should be taken seriously earlier - and not just when retirement age is approaching.