Young Adults And Strokes: What's The Risk?

Strokes can happen at any age, and while they are rare in young adults, they are on the rise. Between 10 and 15% of strokes occur in people aged 18 to 50, and the incidence of strokes in people aged 20 to 44 has risen from 17 per 100,000 in 1993 to 28 per 100,000 in 2015. The risk factors for stroke in young adults are similar to those in older adults and include high blood pressure, obesity, diabetes, high cholesterol, and smoking. However, young adults may also face unique risks related to lifestyle, pregnancy, and genetics. Recognizing the signs of a stroke is crucial, and young adults should seek immediate medical attention if they experience any stroke symptoms to improve their chances of recovery.

Lifestyle factors such as diet, exercise, smoking, and drinking

While stroke is often associated with older people, it can also affect young adults. In fact, between 10 and 15% of strokes occur in people aged 18 to 50, and the rate of strokes in young and middle-aged people is increasing.

Diet

Adopting a plant-based diet centred around vegetables, lentils, beans, seeds, whole grains, fruits, and nuts can help lower your risk of stroke. A study found that for every seven grams of fibre consumed per day, there was a 7% drop in the risk of a first-time stroke. Antioxidant-rich foods are also beneficial, as they help reduce inflammation and prevent plaque buildup in the arteries. Additionally, limiting your salt intake to no more than 1,500 milligrams per day and avoiding high-cholesterol foods can help lower blood pressure, a significant risk factor for stroke.

Exercise

Engaging in regular physical activity can also reduce your risk of stroke. Aim for at least 30 minutes of moderate-intensity exercise, such as walking, golfing, or playing tennis, at least five days a week. Breaking up your exercise routine into shorter sessions throughout the day is also beneficial if you don't have a 30-minute block of time available.

Smoking

Smoking is a well-established risk factor for stroke and is directly linked to an increased risk of clot formation. The more you smoke, the higher your risk of stroke. Quitting smoking is one of the most effective ways to reduce your stroke risk. Even cutting back on the number of cigarettes smoked per day can lower your risk.

Drinking

When it comes to alcohol consumption, moderation is key. Drinking a small amount, such as one glass of red wine per day, may offer some health benefits. However, consuming more than two drinks per day significantly increases your risk of stroke.

High blood pressure, obesity, and diabetes

High blood pressure, often called a silent killer, can start as early as in your 20s. Research suggests that about three per cent of young adults suffer from hypertension. A report by Johns Hopkins Medicine stated that seven per cent of women between the ages of 20 and 34 have high blood pressure.

Obesity is also a growing global health concern, with a rapid increase in morbid obesity. Obesity is associated with an increased risk of cardiovascular disease and an earlier onset of cardiovascular morbidity. The growing obesity epidemic is a major source of unsustainable health costs and morbidity and mortality due to hypertension, type 2 diabetes, and other diseases.

Diabetes, like high blood pressure and obesity, is becoming more common in younger people. According to the Harvard-affiliated Beth Israel Deaconess Medical Center, there has been a rise in diabetes rates among young adults, with no significant improvement in blood sugar control.

It is important to note that these risk factors are often interconnected. For example, obesity increases the risk of high blood pressure and diabetes. Additionally, a healthy diet and regular exercise can help reduce the risk of these conditions and, consequently, lower the chances of having a stroke.

Blood clots and underlying conditions

Blood clots are the most common cause of ischemic strokes, which account for about 80% to 87% of all strokes. Ischemic strokes occur when a vessel supplying blood to the brain is blocked, typically by a blood clot. Blood clots can form in the brain (thrombotic strokes) or elsewhere in the body and travel to the brain (embolic strokes).

Thrombotic strokes occur when a blood clot forms in an artery of the brain. This can happen due to atherosclerosis, or fatty deposits (plaques) that line the vessel walls. These fatty deposits can cause two types of obstructions:

• Cerebral thrombosis: A thrombus (blood clot) that develops at the site of a fatty plaque within a blood vessel supplying blood to the brain.
• Cerebral embolism: A blood clot that forms in the heart or large arteries of the upper chest or neck and then travels to the brain.

Embolic strokes are typically caused by an irregular heartbeat called atrial fibrillation, which can cause clots to form in the heart, dislodge, and travel to the brain. Other underlying conditions that can lead to blood clots and increase the risk of ischemic stroke include:

• Heart defects such as atrial septal defects or ventricular septal defects.
• Microvascular ischemic disease, which can block smaller blood vessels in the brain.
• Sickle cell disease, which can cause the blood to form clumps that turn into clots.
• Clotting disorders or conditions that affect blood clotting, such as coronary heart disease.
• Arterial dissection, which can be caused by whiplash or sports-related trauma, although most dissections occur spontaneously without any trauma.
• Substance abuse, particularly cocaine use, which constricts blood vessels and increases the clumping of blood cells, leading to clotting.
• Hormonal birth control: Hormonal contraceptives have been linked to an increased risk of stroke, especially when combined with smoking.
• COVID-19: Research suggests that adults diagnosed with COVID-19 are more likely to develop blood clots.

It is important to recognize the signs and symptoms of a stroke and seek immediate medical attention. The acronym "F.A.S.T." can help identify stroke symptoms:

• Face: Is their face drooping on one side?
• Arms: Do they have difficulty raising both arms?
• Speech: Is their speech slurred? Are they unable to repeat simple phrases?
• Time: If you observe any of these symptoms, call emergency services immediately.

Stroke symptoms and prevention

Strokes can happen at any age, and while the risk increases with age, they do occur in young people. A stroke, or "brain attack", happens when blood flow to the brain is cut off, which prevents oxygen from reaching the brain, resulting in brain cell death and potential brain damage. The extent of the damage depends on the size and type of stroke.

Symptoms

There are two types of strokes: ischemic and hemorrhagic. Ischemic strokes are the most common, making up about 87% of all strokes, and are caused by a blood clot that cuts off blood flow to the brain. Hemorrhagic strokes occur when blood leaks into the brain or between the brain and the skull.

The acronym FAST is often used to help people recognise the signs of a stroke:

• Face: Drooping on one side of the face, or numbness. Ask the person to smile and check if their smile is uneven.
• Arms: Weakness or numbness in one arm. Ask the person to raise both arms and check if one arm drifts downward.
• Speech: Slurred or strange-sounding words. Ask the person to say a simple phrase.
• Time: Call 911 immediately. Every minute counts when treating a stroke. Note the time when the symptoms first appeared.

Other stroke symptoms include:

• Numbness or weakness on one side of the body
• Confusion, trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Trouble walking, dizziness, loss of balance or coordination
• Severe headache with no known cause
• Sudden falls with no clear cause
• Loss of balance, sometimes with vomiting, nausea, fever, hiccups, or trouble swallowing

Prevention

While some risk factors for strokes are out of your control, there are many that you can influence.

• Maintain a healthy diet and weight. Eat plenty of fresh fruits and vegetables, and limit your intake of salt, high-cholesterol foods, and alcohol.
• Exercise regularly. Aim for at least 30 minutes a day, three times a week.
• Quit smoking.
• Avoid drug use.
• Monitor and manage any heart conditions with your doctor.
• Control your blood pressure and blood sugar.
• Treat atrial fibrillation.
• Take prescribed medications.

Stroke recovery

Strokes can happen at any age, and while they are more common in older adults, approximately 25% of strokes occur in patients younger than 65, with up to 10% of all strokes occurring in those under 50. Young stroke survivors have their whole lives ahead of them, and the recovery process can be challenging and lengthy. Here are some key considerations for stroke recovery in young people:

Social and Economic Challenges:

Young stroke survivors often face unique social and economic challenges. The impact of a stroke can be significant on their careers, financial stability, and family responsibilities. They may experience temporary or permanent changes in employment, requiring adaptive equipment or a change in work responsibilities. Many young survivors are in the prime of their career or raising families, and the life event of a stroke can be very challenging.

Rehabilitation and Support:

Rehabilitation plays a crucial role in stroke recovery. It is a process that requires time, support, and guidance from a team of professionals, including therapy services, social workers, physicians, and nurses. Rehabilitation helps stimulate the muscles and the mind, aiding the body in repairing impaired functions. The sooner rehabilitation begins, the better the odds of recovery. It is also important to address any mental health issues that may arise, as depression can affect up to half of all stroke survivors.

Long-term Care:

Young stroke survivors may require arrangements for physical care, mental redevelopment, and financial needs for an extended period. The rehabilitation process can last for many years, or even a lifetime. It is important to consider the long-term impact on their life expectancy, family roles, and caregiving arrangements.

Motivation and Guidance:

Young stroke survivors may need help staying motivated during their recovery journey. Combining their personal interests with their rehabilitation program can be beneficial. It is also important to guide them towards things that will improve their chances of recovery and help them realize their potential.

Addressing Misconceptions:

Young people often have the misconception that they are not at risk of having a stroke. It is important to address these misconceptions and educate them about stroke risk factors, such as tobacco use and hypertension, which are prevalent among young adults. Additionally, medical professionals should be aware of the risk of incorrect diagnoses due to the young age of the patient.

In conclusion, stroke recovery for young people is a complex and challenging process that requires a multidisciplinary approach. By addressing the social, economic, and medical needs of young stroke survivors, we can help them regain their functionality and improve their quality of life.

Frequently asked questions