Strokes in young people: They’re occurring more often. Why?

Stress, COVID, lifestyle, and diet are all contributing to an increase in people having strokes before their 50s.
Nov. 6, 2023
young person in physical therapy after a stroke.
It is important to know the signs of a stroke. Treating a stroke as quickly as possible increases the chances of preserving brain tissue and, in turn, lessens the patient’s chance of suffering long-term deficits. Photo: Getty Images.

A concerning trend is raising alarms in the medical community, driving awareness of a significant health risk for younger people: strokes.

While the number of strokes in people ages 18 to 45 has been growing at a faster rate nationally than any other age group for the past few decades, the number of young adults having strokes in northern Colorado has nearly doubled over the past few years.

In 2020, about 5% of people who presented with a stroke at UCHealth Poudre Valley Hospital in Fort Collins were between the age of 18-45, but by July of 2023, it was 9%. All of UCHealth’s northern region hospitals – Medical Center of the Rockies, Longs Peak Hospital and Greeley Hospital – have seen similar increases over the last few years.

“It’s a terrifying trend,” said Amanda Werner, UCHealth’s Stroke Program Manager in northern Colorado.

It begs the question: What is causing more young people to have strokes, the leading cause of long-term disabilities in the U.S.?

Werner and her colleagues, including Stroke Program Coordinator Melinda Tafoya, haven’t pinpointed an exact reason for the spike in cases in northern Colorado. In many cases, however, an unhealthy lifestyle of poor diet, limited exercise, smoking and overconsumption of alcohol are factors leading up to a stroke.

“We used to see stroke in younger people mostly happening in those with a genetic predisposition to stroke, like having a blood clotting disorder, but now we are seeing how quickly poor lifestyle choices can affect the body and the overall risk for stroke in younger adults,” Tafoya said.

Strokes in young people

Experts have long known that diet and lifestyle contribute significantly to cardiovascular health. Smoking, excessive drinking, obesity, high blood pressure (hypertension) and high cholesterol are all risk factors for strokes and other cardiovascular diseases.

These lifestyle choices and conditions can weaken or damage the arteries, causing clots to form. A stroke occurs if a clot blocks or ruptures the blood vessels carrying oxygen and nutrients to the brain.

Ischemic strokes, caused by a blocked vessel, account for about 87% of all strokes and 60% in people under 50 in the United States.

Although the majority of ischemic or hemorrhagic strokes happen to people over the age of 55, the increase in stroke occurrences in younger people has medical professionals heeding warnings that strokes are not just a concern for older adults.

“We definitely have seen an increase in poor lifestyle choices for younger people, like unhealthy eating, doing less exercise and activity, and being overweight,” Tafoya said. “Activities like using alcohol and drugs and smoking can also increase your risk for stroke, and these activities are often starting at younger ages.”

According to the latest information from the Centers for Disease Control and Prevention, about 23% of people ages 18 to 39 have hypertension,  which doubles a person’s risk for stroke. Research also shows that in a classroom of 30 youth, ages 12 to 19, one person would have high blood pressure. At the same time, three would have elevated blood pressure (prehypertension). According to the CDC, youth with hypertension and prehypertension are much more likely to have the issues continue into adulthood.

Werner said the downward trend in the health of young people has resulted in an educational shift in stroke assessments within the medical community over the past decade.

“Before, if you were 24 and came to the emergency room thinking you were having a stroke, chances are they likely would not have considered that as an option” she said. “As a whole, practitioners have changed their practice and are no longer dismissing strokes in people of younger ages. Providers, prehospital crews, and nursing now do an amazing job of picking up on stroke symptoms and act quickly when they see them in a patient.”

In recent years, COVID-19 has been added to the region’s list of stroke risk factors, Werner said.

Since the pandemic, doctors have seen more patients with “sticky blood,” where blood thickens, causing abnormal blood clots. Experts believe it happens because of inflammation in the body when it is attacked by the COVID-19 virus.

“Not everyone who gets COVID has clots, but evidence shows an increase initially (in the likelihood of a clot),” said Dr. Jacob Chacko, a cardiologist at UCHealth Heart and Vascular Clinic in northern Colorado.

According to the American Heart Association, COVID-19 is linked to a sharp increased risk of blood-clot-related issues, such as heart attack and strokes, up to a year after a COVID-19 diagnosis compared to people who have never had the virus.

Werner stressed that evidence suggests the coronavirus causes sticky blood, but there is no evidence to suggest COVID-19 vaccines contribute to this issue or increase your risk of stroke.

Tips for reducing alcohol consumption:

  • Track your alcohol intake and determine how and when you could reduce your intake.
  • Have 2-3 consecutive alcohol-free days every week.
  • Replace alcoholic drinks with low or no-alcohol alternatives.
  • Go small. Instead of a large glass of wine, take a small glass, and instead of a pint, take a half or a small bottle.
  • If you use alcohol to relax, find other healthier methods, like exercise, which is a much healthier way to manage stress.

You may find yourself in situations where you know you will likely drink more than the recommended limit. While the health risks of doing this regularly are clear, for one-off occasions, you can reduce the short-term risks to your health by:

  • Setting and sticking to a limit on the total amount of alcohol you drink on any occasion.
  • Drinking more slowly.
  • Drinking with food.
  • Alternating alcoholic drinks with water.

Risk factors for stroke: Why do people have strokes?

  1. Hypertension: High blood pressure increases your heart’s workload and damages arteries and organs over time.
  2. Obesity: One of the most important risk factors for developing cardiovascular diseases, including stroke.
  3. Cigarette smoking: Smoking increases your blood pressure and reduces the oxygen in the blood.
  4. Excessive alcohol consumption: This can cause hypertension, A-fib, diabetes, overweight and liver disease, all of which increase the risk of stroke.
  5. High cholesterol: Causes plaque to build up in the arteries.
  6. Gender: Strokes are more common in women than men, and women of all ages are likelier than men to die from a stroke. Pregnancy and birth control pills pose unique stroke risks for women.
  7. Ethnicity: The risk of having a first stroke is nearly twice as high for Blacks as for Whites. Pacific Islanders are also at a higher risk of a stroke than other races.

Increasing awareness for stroke prevention and recognizing stroke signs

The stroke team in northern Colorado continues to educate community members – both young and old – about stroke risks.

“We do a lot of education at community events, including visiting schools to teach about stroke prevention and identification,” Tafoya said.

Recognizing the signs of a stroke is just as important as prevention because an untreated stroke can lead to rapid damage to brain tissue, Werner said.

“Stroke is the leading cause of disability,” Tafoya said. “Strokes can cause minimal to severe deficits that require long-term therapies and even 24-hour skilled nursing care.”

Quick treatment is paramount because doctors cannot know how a stroke will affect any one person.

” For some people, if the vessels are happy and healthy, you can hang on for a while with collateral circulation,” Werner said.

Collateral circulation means blood travels to an alternate route, bypassing the larger blocked vessel, so the brain still gets some of the nutrients it needs to survive. This helps lessen brain damage caused by a lack of blood and oxygen.

“But we have no idea if someone’s blood vessels will do that,” Werner said. “So for some, it could be several hours, but for others, brain tissue dies within seconds.”

Treating a stroke as quickly as possible increases the chances of preserving brain tissue and, in turn, lessens the patient’s chance of suffering long-term deficits.

“If you’re worried it’s a stroke, call 911,” Werner said. “If you come by ambulance, it could shave valuable minutes off the time it takes for you to get treatment. You lose 1.9 million brain cells each minute that brain tissue doesn’t get blood flow, so every minute counts.”

To help you remember how to spot a stroke, use the phrase F.A.S.T.

Face: Drooping or uneven smile.

Arm weakness

Speech: difficulty speaking, slurred or jumbled speech.

Time to 911 if you observe any of these symptoms.

Werner’s message for young people is clear. “What is good for the heart is good for the brain,” she said. This means that regular exercise and eating healthy – all the things we know help prevent heart attacks and other heart diseases as we age, is also good for our brain and can reduce the risk of stroke.

About the author

Kati Blocker has always been driven to learn and explore the world around her. And every day, as a writer for UCHealth, Kati meets inspiring people, learns about life-saving technology, and gets to know the amazing people who are saving lives each day. Even better, she gets to share their stories with the world.

As a journalism major at the University of Wyoming, Kati wrote for her college newspaper. She also studied abroad in Swansea, Wales, while simultaneously writing for a Colorado metaphysical newspaper.

After college, Kati was a reporter for the Montrose Daily Press and the Telluride Watch, covering education and health care in rural Colorado, as well as city news and business.

When she's not writing, Kati is creating her own stories with her husband Joel and their two young children.