Under 45? Five Things to Know About Strokes

Strokes don't just impact older adults—they can happen to anyone.

by Sarah Ellis Health Writer

You probably picture the typical stroke patient as being elderly. But while that’s generally the case, it's increasingly less so. Stroke hospitalizations are on the rise among people ages 18 to 45, who currently account for 10% to 15% of the 795,000 annual stroke cases in the U.S.

Despite this fact, most young people aren’t aware that they could be at risk for a stroke. A new study from the American Heart Association reveals that one in three young adults don’t even know symptoms to be on the lookout for. “It's a common myth that strokes happen to an older patient population,” says Dhruvil Pandya, M.D., interventional neuroradiologist at Northwestern Medicine Central Dupage Hospital in Chicago. “But that is not the truth.”

Early action is the key to keeping long-term damage from a stroke to a minimum, so here’s what every young person should know.

1. You’re Never Too Young for a Stroke

“Strokes can happen to anyone,” says Enrique C. Leira, M.D., professor of neurology at the University of Iowa Carver College of Medicine in Iowa City and an American Stroke Association volunteer. “It can happen to children; it can happen to young people.” A 2018 report in JAMA Neurology found that stroke prevalence has nearly doubled in younger adults since 1995. Doctors don’t know exactly why this is happening, but it’s a topic of great concern. Dr. Leira explains that “it may be related to increased vascular risk factors in young patients, including management of hypertension.” Dr. Pandya notes that rising obesity, substance abuse, diabetes, and the prevalence of sedentary lifestyles may all be contributing factors, as well.

2. Lifestyle Plays a Role in Your Risk

The causes of strokes in young patients tend to be multifactorial—as opposed to older patients, for whom heart disease is often a primary risk factor, says Dr. Leira. Congenital heart disease, genetic defects, or drug-induced heart problems can all play a role. The CDC notes that people with obesity, high cholesterol, high blood pressure, diabetes, or those who smoke are all at elevated stroke risk. These risks can often be minimized through healthy lifestyle choices. In fact, about 80% of strokes are considered preventable. “Everything that you do from teenage years until now impacts your health,” Dr. Pandya says. “The major factors that impact it are eating habits, lack of physical activity, and poor coping mechanisms for significant stress.”

3. Lack of Awareness Is a Barrier to Treatment

The less that people under the age of 45 know about the prevalence of strokes, the less likely they are to recognize one in a moment of crisis. “Lack of awareness that this could be a stroke is an impediment for treatment,” Dr. Leira says. That's a problem in many ways, including the fact that a full recovery from a stroke is highly dependent on how quickly the person gets help. “Everyone, independent of their age, benefits from rapid treatment,” he says. But that can’t happen unless you know how to spot strokes ASAP.

4. Stroke Symptoms Are the Same at Every Age

Though risk factors differ by age, stroke symptoms are the same for everyone. There’s a common mnemonic device you can use to help you remember them: BE FAST. Dr. Pandya breaks it down: “B stands for any problem with balance, E stands for any problem with vision [eyes], F stands for facial drooping or numbness, A stands for arm weakness or numbness, S stands for any problem with speech, and T stands for time.” These symptoms (with the exception of "T," which references time to get help quickly) usually come on suddenly; spotting one or more of them is reason enough to call 911 without delay.

5. Faster Reaction Equals Better Prognosis

We’ll say it a thousand times: Speed is everything. “The key thing is to react as rapidly as possible,” Dr. Leira says. “Every minute counts. The sooner the diagnosis and treatment, the better the outcomes.” Studies have shown that in general, earlier treatment is associated with better long-term prognosis and minimal brain damage. Dr. Pandya explains that within the first four to five hours of symptom onset, doctors can use thrombolytic medications or perform minimally invasive surgery to remove blood clots in the brain. “We have ways of reversing stroke,” he says, but those methods rely on early action.

Even if you feel certain that stroke won’t affect you, it’s important to know all the facts. You never know when this knowledge could save your life or the life of someone you love.

Sarah Ellis
Meet Our Writer
Sarah Ellis

Sarah Ellis is a wellness and culture writer who covers everything from contraceptive access to chronic health conditions to fitness trends. She is originally from Nashville, Tennessee and currently resides in NYC. She has written for Elite Daily, Greatist, mindbodygreen and others. When she’s not writing, Sarah loves distance running, vegan food, and getting the most out of her library card.