Why are young people dying from this preventable killer condition? Find out how to reduce your risk
Many people think strokes only happen to older people. In reality, strokes can occur at any age, and they can happen to people who appear healthy. Approximately one in five acute stroke patients has none of the standard stroke risk factors, according to a recent study. While there are risk factors to explain the vast majority of strokes, there's a substantial number of cases with no apparent cause, particularly in younger adults.
There are more than 100,000 strokes in the UK each year, about one every five minutes. This leads to 38,000 stroke deaths every year, making it the UK's fourth-biggest killer and a leading cause of disability.
Read on to find out what doctors say is the one thing you need to do to avoid strokes, what research is saying about why younger people are having strokes and why some ‘healthy’ women are at risk.
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What happens when you have a stroke?
A stroke happens when blood flow to part of the brain is cut off, either by a clot blocking an artery or a blood vessel bursting. Without oxygen, brain cells begin to die within minutes — which is why prompt action is crucial. GP Dr Deepali Misra-Sharp says, ‘It is estimated a patient loses around 2 million brain cells a minute at the start of a stroke, which is why rapid diagnosis and treatment are so critical.’
Dr Misra-Sharp explains the three main types of stroke:
Ischemic stroke: Approximately 85% of strokes in the UK are ischemic strokes. An ischaemic stroke happens when a blockage cuts off the blood supply to part of your brain, killing brain cells.
Haemorrhagic strokes: These occur when a blood vessel in the brain bursts and bleeds into the surrounding tissue.
Transient ischaemic attacks (TIA): More commonly known as mini strokes, which are where symptoms come on suddenly but resolve within 24 hours. You get stroke symptoms because a clot is blocking the blood supply in your brain. When the clot moves away, the stroke symptoms stop. These should never be ignored as they are often a warning sign that a more serious stroke could follow.
Signs of a stroke
The main symptoms of a stroke can happen suddenly. They may include:
- Face weakness – one side of your face may droop (fall), and it might be hard to smile
- Arm weakness – you may not be able to fully lift both arms and keep them there because of weakness or numbness in one arm
- Speech problems – you may slur your words or sound confused
The easiest way to remember these symptoms is the word FAST. This stands for:
- Face
- Arms
- Speech
- Time to call 999
There are other signs that you or someone else is having a stroke. These include:
- blurred vision or loss of sight in one or both eyes
- finding it difficult to speak or think of words
- confusion and memory loss
- feeling dizzy or falling over
- a severe headache
- nausea or vomiting
Symptoms of a stroke can sometimes stop after a short time, so you may think you're OK. Even if this happens, seek medical help immediately.
What factors increase the risk of having a stroke?
Certain things can increase your chances of having a stroke. The best way to protect yourself and your loved ones from a stroke is to understand your risk and how to control it. Dr Steve Allder, a consultant neurologist at Re:Cognition Health, explains the factors that can increase your risk.
Age: The older you are, the more likely you are to have a stroke. The chance of having a stroke doubles every 10 years after age 55.
High blood pressure: High blood pressure is a leading cause of stroke. It damages blood vessels, leading to clots that block blood flow or weakened vessels that can burst
High cholesterol: Cholesterol is a waxy, fat-like substance made by the liver and found in certain foods. If we consume more cholesterol than the body can use, the excess cholesterol can accumulate in the arteries, including those of the brain.
Previous stroke or transient ischemic attack (TIA): If you have already had a stroke or a TIA, your chances of having another stroke are higher.
Heart disease: Common heart disorders can increase your risk for stroke. For example, coronary artery disease increases your risk for stroke, because plaque builds up in the arteries and blocks the flow of oxygen-rich blood to the brain.
Diabetes: Diabetes increases your risk for stroke. Diabetes causes sugars to build up in the blood, preventing oxygen and nutrients from reaching the various parts of your body, including your brain.
Obesity: Obesity is linked to higher ‘bad’ cholesterol and triglyceride levels and to lower ‘good’ cholesterol levels. Obesity can also lead to high blood pressure and diabetes.
Why are more young people having strokes?
According to Sentinel Stroke National Audit Programme (SSNAP) data, focusing on stroke patients under the age of 60, in 2013/14, the percentage of stroke patients in this age group was 14.2%. In the latest release (2022/23), this figure has increased to 15.9%.
Additionally, the Oxford Vascular Study encompasses data from over 94,000 individuals registered with GP practices in Oxfordshire over a 20-year period. The study found that between 2002-2010 and 2010-2018, there was a 67% increase in stroke incidence among younger adults aged under 55, and a 15% decrease among older adults.
Among young people who had a stroke, there was a significant increase in the proportion who were in more skilled occupations, particularly for professional or managerial jobs. This could suggest that work-related stress, low physical activity, and long working hours were associated with the risk of stroke.
‘Some rare conditions can predispose some people to stroke at a young age. But most risk factors for stroke in young adults are similar to those in older adults: high blood pressure, diabetes, high cholesterol, and obesity. These conditions are becoming more and more common among younger people,’ GP Dr Olalekan Otulana says.
The role of inflammation in stroke risk for ‘healthy’ women
Recent research, looking at historical data, has revealed why 'healthy' women often suffer from cardiovascular events like heart attacks and strokes. Using data from the Women's Health Study, researchers examined 12,530 healthy women with no standard modifiable risk factors (SMuRFs) and tracked the level of the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) over a 30-year period.
Although these women didn't have SMuRFs, women who had high levels of hsCRP had a 39% increased lifetime risk of stroke and a 52% increased lifetime risk of any major cardiovascular event.
A separate trial using randomised data found that patients can reduce their risk of heart attack and stroke by 38% by using statin therapy, and this should begin in middle age, around 40 years old. Statins lower ‘bad’ LDL cholesterol in the blood by reducing its production in the liver.
Paul Ridker, one of the study’s authors, says, 'While those with inflammation should aggressively initiate lifestyle and behavioural preventive efforts, statin therapy could also play an important role in helping reduce risk among these individuals. Our data clearly show that apparently healthy women who are inflamed are at substantial lifetime risk.’
Illnesses that cause inflammation include autoimmune diseases (such as rheumatoid arthritis and lupus), gastrointestinal disorders (such as Crohn's disease), lung diseases (such as asthma), cardiovascular diseases, and certain types of cancer. If you have an inflammatory illness, Dr Misra-Sharp recommends speaking to your GP about statin therapy.
Lifestyle changes to reduce your risk of strokes
Experts say 80% of strokes are preventable by making lifestyle modifications, and Dr Otulana says the most critical risk factor to manage is your blood pressure. Dr Otulana explains, ‘High blood pressure weakens and damages artery walls, making them more likely to rupture, and it accelerates the build-up of fatty deposits that can cause clots. We call high blood pressure the silent killer — you often don’t feel it, but it silently raises your risk of stroke, heart attack, kidney disease and dementia.’
Other key steps to lower your risk of stroke, according to Dr Misra-Sharp:
Don’t smoke: nicotine and carbon monoxide damage blood vessel lining (endothelium) and make blood ‘stickier,’ increasing the likelihood of clot formation.
Limit alcohol: excess alcohol raises blood pressure and can cause irregular heart rhythms like atrial fibrillation, which dramatically increases the risk of stroke.
Stay active: regular exercise improves circulation, helps control weight, lowers blood pressure, and increases ‘good’ HDL cholesterol, which protects blood vessels.
Eat well: diets high in salt, saturated fat, and sugar can raise blood pressure and cholesterol levels. A Mediterranean-style diet rich in fruits, vegetables, whole grains, fish, nuts, and olive oil has been shown to reduce the risk of stroke.
Manage cholesterol and diabetes: high cholesterol contributes to plaque build-up in arteries; diabetes damages blood vessels and accelerates atherosclerosis. Both conditions need good medical management to reduce stroke risk.
Maintain a healthy weight: excess abdominal fat is linked to insulin resistance, higher cholesterol, and hypertension, all of which increase stroke risk.
Know your family history: genetic factors can predispose you to high blood pressure or early-onset cardiovascular disease, so regular health checks are essential.
Attend your GP for regular check-ups: As we age, our arteries become harder and narrower, making them more susceptible to blockage. If you're over 40, regular check-ups can help identify potential health issues. Contact your GP practice to arrange a check, especially if you have any risk factors such as being overweight or smoking, or have a health condition linked to stroke.
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