New research in Neurology reports that stroke incidence among adults aged 20–54 in Greater Cincinnati and Northern Kentucky nearly doubled from 33.9 to 62.2 per 100,000 between 1993–1994 and 2020. The increase was mainly driven by ischemic strokes, and a small rise in survival means more younger people may live with disability. Risk factors such as hypertension, diabetes, atrial fibrillation and substance use rose over the period, but a lack of a non-stroke comparison group prevents proving causation. Experts urge earlier screening, lifestyle changes, and following the American Heart Association's "Essential 8."
Stroke Rates Are Rising Among Young Adults — What Experts Say You Should Know
Young women more commonly have strokes than young men. - eternalcreative/iStockphoto/Getty Images
New research shows strokes are becoming increasingly common in younger adults — and experts say many cases are preventable. A study published in the journal Neurology found that stroke incidence among adults ages 20–54 in the Greater Cincinnati and Northern Kentucky region nearly doubled between 1993 and 2020.
What the Study Found
Investigators identified 2,076 first-ever strokes in people aged 20–54 from 1993 through 2020. The rate increased from 33.9 cases per 100,000 people in 1993–1994 to 62.2 cases per 100,000 in 2020. The rise was driven mainly by ischemic strokes, which occur when blood flow to part of the brain is blocked.
- Demographics: 738 of the cases (35.6%) occurred in Black individuals and 1,030 (49.6%) in women.
- Survival: There was a small increase in survival after stroke, meaning more younger people may now live with long-term disability.
- Risk Factors: Over the 27-year period, prevalence among stroke patients rose for hypertension (47% → 60%), diabetes (19% → 26%), atrial fibrillation (1% → 6%), and substance use (5% → 40%), with much of the substance-use increase attributed to marijuana.
What Experts Emphasize
"Stroke is a very devastating disease at any age. It is particularly devastating when it happens to younger people," said Dr. David Robinson, senior author of the study and assistant professor of clinical neurology and rehabilitation medicine at the University of Cincinnati College of Medicine.
Researchers caution that because the study lacks a comparable non-stroke control group, it cannot prove these rising risk factors caused the higher stroke rates. Still, experts note that increases in obesity, high cholesterol and sedentary lifestyles likely contribute.
Independent specialists, including Dr. Christopher Anderson (Mass General Brigham) and Dr. Michelle Leppert (Tufts Medical Center), say the findings echo earlier research and are likely generalizable to broader U.S. populations. They call for more research, better prevention, and earlier identification of vascular risk factors.
Practical Steps To Reduce Risk
Experts recommend early and ongoing attention to cardiovascular health. Dr. Robinson points to the American Heart Association's "Essential 8": healthy diet, regular physical activity, no tobacco use, quality sleep, and management of weight, cholesterol, blood pressure and blood sugar. Having a primary care clinician for routine screening is important for catching problems early.
Special guidance for women: Monitor blood pressure closely during pregnancy and the postpartum period. If you experience migraines with visual symptoms while taking estrogen-containing birth control, discuss this with your clinician.
Takeaway
While strokes in young adults remain less common than in older adults, the rising trend is concerning. Early screening, lifestyle changes and prompt treatment of vascular risk factors offer the best chance to prevent strokes and limit long-term disability.
Reporting by Taylor Nicioli. Study published in Neurology.
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