Strokes are on the rise in people as young as 20—here's why
May is American Stroke Month—a national effort to raise awareness of stroke risk, warning signs, and prevention at a time when trends are shifting in concerning ways. While stroke is often associated with older adults, cases are increasingly occurring in younger populations, driven in part by rising rates of hypertension and obesity. This growing shift underscores the need for earlier risk recognition and prevention strategies—especially as more patients in their 20s, 30s, and 40s present with what was once considered a disease of aging.
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The increase in stroke among younger adults is a wake-up call for providers, public health leaders, and health systems.
—May Kim-Tenser, MD
The younger that they afflict us, the more debility and longer the lifetime of debility is on the patient, and on the health system and society as a whole.
—May Nour, MD
Rates of stroke in younger people are increasing.
But what should physicians be doing about it?
“The increase in stroke among younger adults is a wake-up call for providers, public health leaders, and health systems,” May Kim-Tenser, MD, specialist in neurology, vascular neurology, and neurocritical care with Keck Medicine of USC, tells MDLinx. “Addressing it will require interdisciplinary action—from improving prevention and screening to enhancing awareness and reducing health disparities. Early education about strokes in elementary school and early investment in prevention among young adults could yield major long-term health and economic benefits.”
Strokes rise in young people by nearly 15%
Data from the CDC indicates that between 2011–2013 and 2020–2022, stroke prevalence increased 14.6% among adults aged 18–44 years.[] And experts say this is a worrying trend.
“Stroke is a debilitating disease that we know is preventable,” says May Nour, MD, PhD, neurologist and interventional neuroradiologist, and medical director of the UCLA Mobile Stroke Unit. “So 80% of strokes are preventable, and the younger that they afflict us, the more debility and longer the lifetime of debility is on the patient and on the health system and society as a whole. It is very concerning that stroke is happening more prevalently and at younger ages.”
Roughly one in seven strokes happen to people aged 15 to 49. It is believed risk factors like obesity, high blood pressure, and diabetes in young people are contributing to strokes among this group.[]
Related: This sex act has been linked to signs of brain damage in young womenMichael Abraham, MD, specialist in neurology, neurocritical care, and neuroradiology at the University of Kansas Health System, says it’s possible some other lifestyle factors may also be playing a role.
“I speculate a couple things. One, with more people on their phones and living from their phones, they are less active, making them prone to a sedentary lifestyle. Two, more and more I hear about chiropractor neck manipulation, which can be a cause of carotid and vertebral artery dissection, which can cause a stroke,” he tells MDLinx.
The societal impact
Although the majority of strokes occur in older adults, Dr. Kim-Tenser argues the impact of strokes in younger years can be significant.
“While the numbers may still be lower than in older adults, strokes in younger people result in long-term disability during what should be peak years of productivity, parenting, and career development. This reflects not only a medical issue but a societal and economic challenge as well,” Dr. Kim-Tenser says.
“Younger adults generally have lower short-term mortality rates after stroke compared to older adults, largely due to fewer comorbidities and better physiological reserve," she continues. "However, this can be misleading. Young stroke survivors often face decades of post-stroke morbidity, including cognitive impairment, depression, and reduced quality of life. Moreover, certain types of stroke in the young—such as hemorrhagic strokes or those related to drug use or congenital abnormalities—can have poor outcomes."
As more young people are experiencing strokes, young women in particular are facing rising cases, despite having fewer classic risk factors for stroke. Experts say migraines, pregnancy, and menopause are among the likely culprits for this patient population.[][][]
Related: 5 culprits behind rising cases of stroke in young women—are you overlooking new risk factors?For prevention, address risk factors
Dr. Nour argues physicians have an important role to play in identifying and addressing risk factors for stroke among young people.
“Addressing someone's risk factors is one of the most positive steps that we can take towards improving or decreasing risk of stroke in younger individuals. We know that 80% of stroke is preventable. If we identify these specific risk factors in the younger individuals, then we can work on prevention rather than treating the symptoms or sequela after it happens,” she says.
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