Stroke rates among adults aged 20 to 54 nearly doubled over a 27-year period in a large US population study, with the increase driven primarily by ischaemic strokes. The findings also show that more younger adults who experience stroke are surviving the acute event, potentially increasing the number living with long-term disability.
Researchers examined first-ever strokes among 2,076 adults aged 20 to 54 in the Greater Cincinnati and Northern Kentucky region between 1993 and 2020. The overall stroke rate increased from 33.9 cases per 100,000 person-years in 1993-1994 to 62.2 in 2020.
The increase was largely attributable to ischaemic stroke, which occurs when blood flow to part of the brain is blocked. Rates of ischaemic stroke rose from 23.8 to 47.3 cases per 100,000 person-years over the study period. No comparable increase was identified for intracerebral haemorrhage or subarachnoid haemorrhage.
Several health conditions and behaviours also became more common among younger adults experiencing stroke. Rates of high blood pressure, diabetes and atrial fibrillation increased over time, alongside substance use. Substance use rose from 4.6% of younger adults with stroke in 1993-1994 to 40.2% in 2020, with much of the increase reflecting marijuana use.
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Despite the rise in stroke incidence, 30-day mortality declined modestly after adjustment for age, race and sex, falling from 11.7% in 1993-1994 to 9.4% in 2020. The improvements were largely observed among people with intracerebral haemorrhage and subarachnoid haemorrhage.
The researchers said the findings highlight the importance of identifying and managing stroke risk factors earlier in adulthood. However, the study could not determine whether changes in risk factors directly explain the increase in stroke rates because comparable information was not available for people without stroke.
This news item has been summarised using AI and checked by humans before publication.
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