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By Stephen Beech
More young people are suffering strokes than 30 years ago — with drug abuse a key factor, according to new research.
Stroke rates among adults ages 20 to 54 nearly doubled over a 27-year period, reveal the findings.
Scientists say the rise was driven primarily by ischemic strokes, the most common type of stroke.
Researchers found increases over time in high blood pressure, diabetes, irregular heartbeat and substance use among younger adults who had strokes.
But while strokes became more common in younger adults, the number dying within 30 days of suffering a stroke showed a modest decline.
The findings of the American study, published in the journal Neurology, suggest a growing number of younger stroke survivors may be living with long-term disability.
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Study author Dr. Emily Fisher, of the University of Cincinnati, said: "While stroke has traditionally been considered a disease of older adults, our findings show that stroke is becoming increasingly common in younger adults.
"At the same time, more people are surviving these strokes, which means more younger adults may be living with the long-term effects of stroke."
The study analyzed strokes in the Greater Cincinnati and Northern Kentucky region from 1993 through 2020.
Researchers identified 2,076 first-ever strokes among adults aged 20 to 54.
The findings showed that the rate of strokes among younger adults increased from 33.9 cases per 100,000 person-years in 1993-1994 to 62.2 cases per 100,000 person-years in 2020.
Dr. Fisher said the increase appeared to be driven by ischemic stroke, which occurs when blood flow to part of the brain is blocked.
The ischemic stroke rate rose from 23.8 cases per 100,000 person-years in 1993-1994 to 47.3 cases per 100,000 person-years in 2020.
The research team didn't find similar increases for other types of stroke such as intracerebral hemorrhage, a bleeding stroke within the brain, or subarachnoid hemorrhage, a bleeding stroke around the brain.
The findings showed that some health problems became more common over time among people who had a stroke.
There were increases in high blood pressure, diabetes, irregular heartbeat — also known as atrial fibrillation — and substance use among younger adults who had stroke.
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Substance use among younger adults with stroke increased from 4.6% in 1993-1994 to 40.2% in 2020, with much of the increase reflecting cannabis use.
The research team also looked at 30-day death rates after stroke.
After adjusting for age, race and sex, they found a slight decline over time, from 11.7% in 1993-1994 to 9.4% in 2020.
Improvements were largely seen among people with intracerebral hemorrhage and subarachnoid hemorrhage.
Dr. Fisher said: "Our findings highlight the importance of identifying and managing stroke risk factors early in adulthood."
She added: "Additional research is needed to better understand what is driving these trends and how they can be reversed."
