Why More Middle-Aged Adults Are Having Strokes — and How to Prevent One

Meanwhile, stroke rates hold steady for adults 65 and older

Rachel Nania,

AARP

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En español

Published May 16, 2023

/ Updated May 23, 2024

Illustration of human brain with stroke symptom

Getty Images

Every 40 seconds, someone in the U.S. has a stroke — a disruption of blood flow to the brain. And that someone might be younger than you think.

While stroke is often thought of something that hits later in life, the reality is, anyone can have a stroke. And research shows that stroke rates are rising in young and middle-aged adults.

A May 23 report from the Centers for Disease Control and Prevention (CDC) found stroke prevalence in adults younger than 65 rose by roughly 15 percent during the last decade. The increase was nearly 16 percent among those ages 45 to 64, while trends remained consistent for those 65-plus.

More on Stroke Symptoms and Prevention

How to tell if someone is having a stroke

What to do (and not do) when someone is having one

What are the symptoms of a ministroke

7 habits to reduce your risk of stroke

Meanwhile, a 2022 study published in the journal Stroke found an 11 percent overall rise in intracerebral hemorrhage strokes over a 15-year period, and increases were highest in younger and middle-aged adults. This type of stroke, which is more deadly and disabling than other types, occurs when blood vessels in the brain rupture and bleed. Experts called the study’s findings “very alarming” and say it stresses the need for earlier intervention.

“This is obviously a cause for concern,” says Ahmed Itrat, M.D., stroke medical director for Cleveland Clinic Akron General.

Chronic conditions, overlooked symptoms may contribute

What’s behind the rise in stroke in the younger set? Experts say health conditions that increase a person’s risk for stroke are becoming more common in this age group.

Risk Factors for Stroke

Health conditions that can increase risk:

Previous stroke or mini stroke
High blood pressure
High cholesterol
Heart disease
Diabetes
Obesity
Sickle cell disease

Behaviors that can increase risk:

A diet high in saturated fats, trans fat and cholesterol
Physical inactivity
Drinking too much alcohol
Tobacco use

Source: Centers for Disease Control and Prevention

The authors of the CDC report note that during the study time frame, rates of obesity among males increased from 28 percent to 43 percent and among females from 33 percent to 42 percent. The highest prevalence was among adults ages 40 to 59 at 45 percent.

The incidence of hypertension, or high blood pressure, also increased in that time frame to nearly half (47 percent) among adults ages 45 to 64. And a 2020 CDC report shows that the prevalence of high cholesterol, another risk factor for stroke, is greatest among adults 40 to 59 years old.

“So, conditions that used to not really pop up until people were in their 60s and older are now occurring in people who are younger,” says Mitchell Elkind, M.D., chief clinical science officer at the American Heart Association.

Another explanation has to do with overlooked symptoms. A study published in 2020 found that almost 30 percent of adults under the age of 45 don’t know the five most common symptoms of a stroke: numbness of the face, arms or legs; confusion or trouble speaking; loss of balance; trouble seeing in one or both eyes; and severe headache.

Even if people are aware of these warning signs, “there are many other stroke symptoms that people need to recognize,” Itrat says.

Dizziness is one example, he says, and so is the nausea and vomiting that can sometimes accompany it. “And people oftentimes dismiss it as being some sort of a viral gastroenteritis or something else, and they don’t make it to the hospital in time to get the treatment that they need,” Itrat says.

If a patient does act on concerning symptoms and makes it to the hospital, it’s possible that health care providers miss the diagnosis, Elkind says: “Doctors sometimes ignore stroke-like symptoms because they say, ‘Oh, this person can’t be having a stroke. They’re too young for it.’”

Seeking care quickly is key when it comes to stroke. Treatments have improved in recent years. Still, Itrat says, “there’s a very limited window in terms of what we can achieve.”

Reduce your risk for stoke at midlife and beyond

Roughly 80 percent of strokes are preventable, according to the CDC, and both Elkind and Itrat say the best way to lower your risk for one is to stay on top of routine doctor’s visits — especially if you have a family history of cardiovascular disease. Get your blood pressure, cholesterol and blood sugar tested regularly so that if numbers are high, you can manage them.

Know the Warning Signs of Stroke

Remember BE FAST:

Balance loss

Eyesight changes

Face drooping

Arm weakness

Speech difficulty

Time to call 911

Source: Duke Health

The CDC estimates 1 in 3 U.S. adults with hypertension (high blood pressure) don’t know they have it and aren’t being treated for it. “Blood pressure is a very controllable thing, and it's obviously a disaster when it's not managed because it can lead to a stroke,” Elkind says.

High cholesterol is another threat that can go unnoticed, because, like high blood pressure, it comes without symptoms.

“You want to prevent any kind of risk factors which would, down the road, have an impact on overall health and specifically brain health and stroke risk,” Itrat says.

A few other things that can lower your stroke risk: Avoid smoking, stay physically active, get enough sleep (at least seven hours, says the American Heart Association) and eat a healthy diet. Both Elkind and Itrat point to a Mediterranean-style diet, which emphasizes plant-based foods and healthy fats. A recent report from the American Heart Association scored the DASH (Dietary Approaches to Stop Hypertension) diet highest for its heart-health benefits.