After researchers at the University of Cincinnati, Ohio, found that those aged between 20 and 54 were almost twice as likely to have a stroke now than they were around three decades ago, experts have told Newsweek how young people could reduce their risk. Stroke risk is typically known to increase with age (although strokes can occur at any age), making the finding that rates are increasing among the young notable. It is also concerning because the "health burden of having a stroke at a young age is simply staggering," George Howard, a senior scientist and professor at the University of Alabama at Birmingham, told Newsweek.
"You can live for years after having a stroke, with substantial residual impact both on the cost of stroke, and also on the quality of life impact for the patient," he added. However, he said that, while the number of cases is increasing, strokes in younger patients are still "relatively rare." "I think we need to consider these trends deeply concerning, and perform additional research to replicate these findings and undertake causal analyses to identify the factors that are driving these changes in stroke incidence," Dr. Lee Schwamm, a professor of neurology and of biomedical informatics and data science at Yale University, told Newsweek: Across the U.S., every 40 seconds someone has a stroke, and every 3 minutes and 14 seconds, someone dies from a stroke, according to data from the Centers for Disease Control and Prevention (CDC).
The main known risk factors for stroke include, according to the Stroke Association: Schwamm said that the things that prevent heart disease can also prevent stroke. He pointed to the American Heart Association's "Life's Essential 8", which includes four things people should do with their doctor (managing blood pressure, blood sugar, blood cholesterol and weight) and four lifestyle factors (having a healthy diet, regular physical activity, avoiding tobacco and getting a good night’s sleep). For young people in particular, Schwamm said that he would advise "getting regular checkups and ensuring you have a basic set of bloodwork screening for risk factors including cholesterol measurement by age 18 at the latest." He added that knowing family history can help and that if you have a known risk factor, taking steps to engage in self-management is important.
Howard also said that "preventing hypertension, preventing diabetes, and never starting smoking, seems to be the best course" for young people to reduce their risk of stroke, although he emphasized that "not a lot is known about risk factors for stroke in the young." When it comes to hypertension and diabetes, he said risk can be reduced by looking at weight and diet. He also said risk could "really be reduced" by primordial respect prevention—which is a relatively new concept in preventative medicine that involves preventing the development of risk factors by addressing the root causes of chronic disease, a lot of which revolves around healthy lifestyle and behaviors. Why younger populations could be experiencing higher rates of stroke is not yet clear.
Howard said that currently, the field doesn't even "have good suggestions for what might be going on, however, it is certainly something that we need to understand much better." The University of Cincinnati noted in their study though that over the 27-year time period, alongside increasing rates of stroke, hypertension, diabetes, atrial fibrillation (irregular heart rhythm) and substance use were more common. Schwamm said he thought it is "quite likely that much of the increase is due to the growing prevalence of factors such as diabetes, obesity and hypertension among younger patients whether known or unrecognized, which is expressing itself as ischemic stroke at younger ages." Rates of diabetes are expected to rise among young people over the next 40 years, according to data from the CDC. Obesity rates are also sharply increasing among adults and children, according to the American Heart Association (AHA), citing a study which found that across two decades, there was a 37 percent increase in obesity and more than a two-fold increase in severe obesity among both adults and youth.
Other studies have also shown that hypertension has significantly increased among young Americans in the last 45 years. Lynda Lisabeth, a professor of epidemiology at the University of Michigan, told Newsweek that the increasing prevalence and burden of traditional stroke risk factors, including hypertension, diabetes, obesity, and atrial fibrillation could be a reason for the trend, particularly as "studies of younger adults have documented increasing stroke incidence alongside increasing prevalence of these risk factors." She also said that "suboptimal detection, treatment, and control of these risk factors, particularly hypertension, may also contribute to the rising stroke risk at younger ages," and that changing U.S. demographics may provide an "additional explanation, as racial and ethnic groups differ in stroke risk and burden, with some groups experiencing disproportionately high stroke risk at younger ages." Schwamm also said that it is "possible that other factors are playing a role that are not measured in this dataset," such as the fact that "cannabis and tobacco are frequently consumed via vaping rather than smoking and if this method of consumption was disproportionately more common among younger patients, it could be that these new methods of consumption reflect an unrecognized risk separate from the compounds themselves." "Or it could be that changes in the environment are exerting an influence that is more frequently experienced by younger patients," he added. Fisher E et al. (2026) Stroke in the Young: Incidence, 30-Day Case Fatality Rates, and Risk Factors Over Time in a Population-Based Study.
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