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Many believe strokes only affect the elderly, but this is a dangerous misconception. Young adults are increasingly susceptible to strokes, with lifestyle factors and underlying health conditions playing a significant role. This alarming trend highlights the importance of recognizing stroke risks and promoting healthy habits from a young age. Learn more about how young people can have strokes in this day and age as you read on.
A stroke, often referred to as a brain attack, occurs when the blood supply to a part of the brain is interrupted or reduced. This prevents brain tissue from receiving oxygen and nutrients, leading to the rapid death of brain cells. There are two main types of strokes: ischemic, caused by a blockage in a blood vessel supplying the brain, and hemorrhagic, caused by bleeding in or around the brain.
Stroke risk generally increases with age and the presence of certain health conditions like high blood pressure and diabetes. However, it can affect anyone, including young and seemingly healthy individuals. Factors like genetics, lifestyle choices (e.g., smoking, poor diet), and even certain medical conditions can increase the risk of stroke in younger populations.
Recent data from the Centers for Disease Control and Prevention (CDC) shows a concerning rise in stroke prevalence among young adults(1) (18-44) and middle-aged adults (45-64), with increases of up to 15.7% observed between 2011-2013 and 2020-2022.
Recent research highlights the growing concern about strokes in young people. A 2023 study published in the journal Stroke found that the incidence of ischemic stroke is rising among young adults(2), particularly those aged 25 to 44. This increase is partly attributed to the growing prevalence of traditional risk factors like obesity and diabetes in this age group.
Other research works explored the unique risk factors for stroke in young adults, including migraine with aura, oral contraceptive use, and pregnancy(3). These studies underscore the need for targeted prevention strategies in this population.
Also read: 5 Compelling Reasons Why You Should Get Tested for Heart Disease in Your 20s
Strokes are increasingly affecting young adults, an alarming and concerning trend.
Several factors contribute to this rise, including lifestyle choices, underlying health conditions, and, in some cases, genetics. To better understand what causes stroke in young people, we broke down the risk factors into traditional risks and those commonly found among this cohort.
Stroke, a leading cause of death and disability, traditionally has been associated with a set of well-known risk factors. These factors include high blood pressure (including maternal hypertension), high cholesterol, smoking, diabetes, and obesity, all of which can damage blood vessels and increase the risk of clot formation. Below are crucial details on how these conditions can lead young people closer to strokes.
Hypertension, or high blood pressure, is a major risk factor for stroke, even in young people. It damages blood vessels, making them more susceptible to narrowing and clotting. If a clot blocks blood flow to the brain, a stroke occurs, potentially leading to permanent brain damage or death. While less common in younger individuals, about 23% of people aged 18-39 have hypertension(4), increasing their stroke risk significantly.
Those with diabetes are closer to developing strokes than individuals without the condition. This is especially true if the condition is poorly managed, as consistent elevation in the serum glucose levels damages the blood vessels, including those in the brain. This damage increases the risk of clots and blockages, leading to ischemic stroke.
Although diabetes is often associated with older adults, there’s a concerning rise in type 2 diabetes among young people due to factors like obesity and sedentary lifestyles. This trend contributes to an increase in stroke risk within this demographic. The exact prevalence varies, but studies suggest that diabetes may be present in up to 10% of young stroke patients(5), highlighting a significant and growing concern.
Excess weight can lead to high blood pressure, high cholesterol, and diabetes, all of which damage blood vessels and increase the risk of blood clots. Alarmingly, obesity rates have been rising in young adults, contributing to the increase in strokes within this age group. Overweight and obesity affect a substantial number of young adults in the UK and USA, impacting 22% to 35% of those aged 18 to 23(6).
Nicotine, the ingredient that makes smoking addictive, raises blood pressure and damages blood vessels. Other chemicals in cigarettes can thicken the blood, promoting clot formation.
While smoking rates have declined among youth, it remains a concern, with many young people taking up vaping. Though perceived as safer, vaping also contains nicotine and harmful chemicals that may contribute to cardiovascular problems and stroke risk(7).
Did You Know? You can order a blood test for smoking to keep track of the nicotine level in your system, making it easier for you to quit based on a tailored plan. Learn more about the nicotine/cotinine test and why it matters in managing withdrawal syndrome.
High cholesterol, particularly high levels of low-density lipoprotein (LDL) cholesterol, can contribute to stroke in young people. LDL cholesterol builds up in artery walls, forming plaque that hardens and narrows the arteries. This process, called atherosclerosis(8), restricts blood flow to the brain. If a piece of plaque breaks off or a blood clot forms, it can completely block an artery, leading to a stroke.
Pro tip: You can keep track of your bad cholesterol, along with other types, starting with a reliable lipid panel with an LDL/HDL ratio blood test. Have your healthcare provider diagnose while having a general overview of the typical lipid panel results.
The physiological changes during pregnancy and the postpartum period can increase stroke risk in young women. Hormonal shifts, increased blood volume, and changes in blood clotting factors can contribute to the formation of blood clots(9). Additionally, conditions like preeclampsia, characterized by high blood pressure, further elevate stroke risk. These factors, combined with potential postpartum complications, make this a vulnerable time for stroke.
Young adults face unique risk factors for stroke that go beyond the traditional ones. These include conditions like migraines with aura, clotting disorders, and illicit drug use, which can significantly increase their stroke risk. Learn more about these conditions below and how they solidify the links between young people and strokes.
A study in Neurology found that young adults with migraine with aura(10) had a significantly higher risk of stroke compared to those without aura, even after adjusting for other risk factors. The aura, often involving visual disturbances, is thought to be caused by a wave of electrical activity in the brain that can temporarily affect blood flow. This disruption, combined with other potential factors like inflammation and changes in blood vessel walls, may increase the likelihood of blood clots forming.
Cervical artery dissection (CeAD) occurs when a tear forms in the lining of an artery in the neck, creating a flap where blood can pool and clot. This clot can then block blood flow to the brain, leading to a stroke. CeAD is a major cause of stroke in young adults(11), often affecting individuals who are otherwise healthy and lack traditional stroke risk factors. While the exact cause of CeAD is unknown, it can be triggered by minor trauma or even everyday activities like coughing or sneezing.
Many illicit drugs, like cocaine and amphetamines(12), can cause sudden spikes in blood pressure and disrupt heart rhythm, leading to blood clots and, ultimately, stroke. These drugs can also damage blood vessels, making them more susceptible to rupture and causing a hemorrhagic stroke.
Unfortunately, illicit drug use is a growing concern among young adults, with 1 in 13 young people(13) developing a disorder around its use. Plus, the increased accessibility and social pressures contribute to this risky behavior.
When the body fights an infection (e.g., viral infections like COVID-19(14)), it releases inflammatory substances that can damage blood vessels and induce blood clot formation. Young people may be more susceptible to this due to their active immune systems and potential exposure to various infections.
Yes, you can get a stroke in your 20s, though it’s less common than in older adults. Various factors, including genetic conditions, blood clotting disorders, head trauma, and lifestyle choices like smoking and drug use, can cause strokes in young people. While the overall prevalence is lower in this age group, studies suggest that stroke in young adults is increasing, highlighting the importance of awareness and prevention.
A healthy person can have a stroke. While risk factors like high blood pressure and smoking increase the likelihood, spontaneous bleeding in the brain can occur due to weaknesses in blood vessels, such as aneurysms, that rupture. Blood clots causing strokes can also form in healthy individuals due to factors like dehydration, prolonged immobility, or genetic predispositions that affect the clotting process.
Preventing a stroke largely comes down to a healthy lifestyle. This includes maintaining a healthy blood pressure and cholesterol, eating a balanced diet, exercising regularly, and avoiding smoking and excessive alcohol consumption. Stroke prevention also includes managing underlying health conditions like diabetes and atrial fibrillation.
Strokes are no longer confined to older populations. Young people are increasingly susceptible to strokes due to rising rates of obesity, high blood pressure, and other risk factors. For this reason, more emphasis has to be placed on preventing stroke through diet, exercise, and regular checkups. This also includes checking your cholesterol regularly through a lipid panel blood test.
1 Imoisili OE, Chung A, Tong X, Hayes DK, Loustalot F. Prevalence of Stroke — Behavioral Risk Factor Surveillance System, United States, 2011–2022. MMWR Morb Mortal Wkly Rep 2024;73:449–455. DOI: http://dx.doi.org/10.15585/mmwr.mm7320a1
2 Bukhari S, Yaghi S, Bashir Z. Stroke in Young Adults. J Clin Med. 2023 Jul 29;12(15):4999. doi: 10.3390/jcm12154999. PMID: 37568401; PMCID: PMC10420127.
3 Carlton, C., Banks, M., & Sundararajan, S. (2018). Oral Contraceptives and Ischemic Stroke Risk. Stroke, 49(4). https://doi.org/10.1161/strokeaha.117.020084
4 High blood pressure a concern for adolescents and young adults in U.S. (2024). American Heart Association. https://newsroom.heart.org/news/high-blood-pressure-a-concern-for-adolescents-and-young-adults-in-u-s
5 Kernan, W. N., Forman, R., & Inzucchi, S. E. (2022). Caring for Patients With Diabetes in Stroke Neurology. Stroke, 54(3). https://doi.org/10.1161/strokeaha.122.038163
6 Poobalan A, Aucott L. Obesity Among Young Adults in Developing Countries: A Systematic Overview. Curr Obes Rep. 2016 Mar;5(1):2-13. doi: 10.1007/s13679-016-0187-x. PMID: 26883372; PMCID: PMC4796326.
7 Zong H, Hu Z, Li W, Wang M, Zhou Q, Li X, Liu H. Electronic cigarettes and cardiovascular disease: epidemiological and biological links. Pflugers Arch. 2024 Jun;476(6):875-888. doi: 10.1007/s00424-024-02925-0. Epub 2024 Feb 20. PMID: 38376568; PMCID: PMC11139732.
8 An J, Zhang Y, Zhou H, Zhou M, Safford MM, Muntner P, Moran AE, Reynolds K. Incidence of Atherosclerotic Cardiovascular Disease in Young Adults at Low Short-Term But High Long-Term Risk. J Am Coll Cardiol. 2023 Feb 21;81(7):623-632. doi: 10.1016/j.jacc.2022.11.051. PMID: 36792277; PMCID: PMC10251803.
9 Maughan BC, Marin M, Han J, Gibbins KJ, Brixey AG, Caughey AB, Kline JA, Jarman AF. Venous Thromboembolism During Pregnancy and the Postpartum Period: Risk Factors, Diagnostic Testing, and Treatment. Obstet Gynecol Surv. 2022 Jul;77(7):433-444. doi: 10.1097/OGX.0000000000001043. PMID: 35792687; PMCID: PMC10042329.
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11 Engelter ST, Enz LS, Ravanelli F, Kaufmann JE, Gensicke H, Schaedelin S, Luft AR, Globas C, Goeggel-Simonetti B, Fischer U, Strambo D, Kägi G, Nedeltchev K, Kahles T, Kellert L, Rosenbaum S, von Rennenberg R, Brehm A, Seiffge D, Renaud S, Brandt T, Sarikaya H, Zietz A, Wischmann J, Polymeris AA, Fischer S, Bonati LH, De Marchis GM, Peters N, Nolte CH, Christensen H, Wegener S, Psychogios MN, Arnold M, Lyrer P, Traenka C. The 6-months follow-up of the TREAT-CAD trial: Aspirin versus anticoagulation for stroke prevention in patients with cervical artery dissection. Eur Stroke J. 2025 Feb 5:23969873251315362. doi: 10.1177/23969873251315362. Epub ahead of print. PMID: 39910883; PMCID: PMC11803590.
12 Dominic P, Ahmad J, Awwab H, Bhuiyan MS, Kevil CG, Goeders NE, Murnane KS, Patterson JC, Sandau KE, Gopinathannair R, Olshansky B. Stimulant Drugs of Abuse and Cardiac Arrhythmias. Circ Arrhythm Electrophysiol. 2022 Jan;15(1):e010273. doi: 10.1161/CIRCEP.121.010273. Epub 2021 Dec 28. PMID: 34961335; PMCID: PMC8766923.
13 American Addiction Centers. (2022, July 26). Drug Education Survey. American Addiction Centers. https://americanaddictioncenters.org/blog/drug-education-survey
14 Clarke M, Falcione S, Boghozian R, Todoran R, Zhang Y, C Real MG, StPierre A, Joy T, Jickling GC. Viral Infection and Ischemic Stroke: Emerging Trends and Mechanistic Insights. J Am Heart Assoc. 2024 Sep 17;13(18):e035892. doi: 10.1161/JAHA.124.035892. Epub 2024 Sep 11. PMID: 39258541.
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