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What exactly is a stroke? -

According to the WHO, a stroke occurs when the blood supply to the brain is interrupted, depriving brain cells of oxygen and nutrients. This can lead to cell death and disability.

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Global issue -

In 2021, stroke was among the leading global causes of death, along with ischaemic heart disease and COVID-19.

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Main causes of death -

About one in 10 people worldwide die from stroke. It's the third leading cause of death globally, and the fifth leading cause of death in the US.

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Growing numbers -

Research suggests that strokes could lead to 10 million deaths a year by 2050. This is due to population growth and aging.

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Affecting younger people -

While strokes typically affect older people, a recent report released by the US Centers for Disease Control and Prevention (CDC) found a concerning trend: deaths from stroke among Americans aged 45-64 increased by 19% from 2013 to 2019.

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Affecting younger people -

This was confirmed by a new study in the Lancet Neurology journal, which found that while stroke rates declined among adults over 70, they increased among younger adults, particularly those under 55.

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Concerning stats -

"It's important to know that stroke can happen at any age," says Omoye Imoisili, an internal medicine doctor and lead author of the CDC study. This is particularly alarming, as stroke prevalence among 18-44-year-olds rose by a tenth of a percentage point, representing a relative increase of 15 percent.

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Why the increase? -

While younger adults still make up a small proportion of overall strokes, rates are climbing quickly in these younger groups with no increases seen in older adults. But why?

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Obesity -

Since 1990, obesity's contribution to stroke risk has risen by 88% globally. Excess weight can strain the heart and blood vessels, leading to high blood pressure, type 2 diabetes, and high cholesterol. These conditions contribute to plaque buildup in the arteries, increasing the risk of blood clots and stroke.

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Sugar intake -

The study also linked an increase in stroke cases to the rising consumption of sugar-sweetened beverages. High blood sugar levels can damage blood vessels, leading to inflammation, nerve damage, and blood clot formation.

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Air pollution -

Air pollution accounts for about 30% of worldwide strokes. This includes pollution from outdoor and indoor sources, such as household burning of fuels.

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Climate change -

According to the Lancet study, the impact of higher air temperatures on stroke incidence has increased by 72%. While higher temperatures are a concern, temperature extremes in both directions can influence stroke risk.

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Climate change -

Recent studies suggest that cold temperatures may have a more significant impact on stroke rates and deaths than hot temperatures.

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Opioid abuse -

The CDC report suggests that the opioid epidemic may have contributed to the rise in stroke rates. States like Ohio and Tennessee, hard-hit by the opioid crisis, experienced significant increases in stroke cases.

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Chronic conditions -

Poorly managed diabetes can lead to high cholesterol, high blood sugar, and high blood pressure, all of which are major risk factors for stroke. The report indicates that the rising prevalence of type 2 diabetes among young adults has contributed to an increase in stroke cases over the past 15 years.

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Socioeconomic factors -

Certain communities, including Native Americans, Native Hawaiians/Pacific Islanders, and Black Americans, experienced higher rates of stroke. The CDC study suggests that this may be due to factors such as chronic health conditions, socioeconomic disparities, and systemic barriers to healthcare.

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Main risk -

However, the single biggest risk factor for stroke worldwide—including among young adults—is still high blood pressure, accounting for over half of all cases, as the Lancet study points out.

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“Silent killer” -

A recent study published in JAMA Network Open revealed that over half of all Americans with high blood pressure are unaware of their condition, including a staggering 93% of those aged 18 to 44.

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Monitoring is key -

It's not just those with extremely high blood pressure who are at risk. Valery Feigin, a stroke researcher and lead author of the Lancet study, highlights that most strokes and heart attacks occur in individuals with only slightly elevated blood pressure.

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Bright side -

The good news is that high blood pressure can be managed easily. A healthy blood pressure reading is below 120/80, which can be achieved through lifestyle changes and, if necessary, medication.

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Prevention -

Feigin emphasizes that the vast majority of strokes are preventable. Consulting with a doctor to check blood pressure and assess personal risk factors, such as family history and lifestyle, is a crucial first step.

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Lifestyle changes -

The next step is to make gradual lifestyle changes to reduce weight, high blood pressure, and high blood sugar.

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Sodium intake -

One major lifestyle change to lower blood pressure is reducing sodium intake, Feigin says. When we consume too much sodium, our bodies retain more water, which increases blood volume and puts extra strain on the heart and blood vessels. 

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Ultra processed foods -

Ultra-processed foods, like processed meats, salty snacks, and condiments like ketchup, are major sources of excess sodium in our diets. To reduce sodium intake, it's important to be mindful of food labels and choose low-sodium options.

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Sugary drinks -

Sugar-sweetened beverages, such as soda, juice, and energy drinks, contribute significantly to high blood sugar levels. Consuming these drinks regularly can increase the risk of obesity, type 2 diabetes, and other health problems, all of which are linked to stroke.

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Weight -

Excess weight can lead to health conditions like high blood pressure, high cholesterol, and type 2 diabetes, increasing the risk of stroke. A balanced diet rich in healthy fats, protein, and fiber is essential for weight management and overall health.

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Physical activity -

Regular exercise is not only effective for weight management. It helps lower LDL ("bad") cholesterol, raise HDL cholesterol, reduce blood pressure, and manage stress levels, all of which contribute to a reduced risk of heart disease and stroke.

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Tobacco -

Another major risk factor for stroke, smoking damages blood vessels, increases blood pressure, and accelerates plaque buildup in the arteries. Quitting can significantly reduce the risk of stroke and improve overall health.

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Alcohol -

Beyond elevating blood pressure, alcohol abuse can damage the heart muscle, increase the risk of atrial fibrillation, and impair liver function. These factors can lead to blood clots and increase the risk of stroke. Reducing or eliminating alcohol consumption is an important preventive measure.

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Cholesterol control -

To reduce high LDL cholesterol levels, specialists recommend limiting intake of red meat, full-fat dairy products, and processed foods. In turn, consuming more fiber-rich foods and healthy fats, and engaging in regular physical activity can help balance cholesterol levels.

Sources: (National Geographic) (World Health Organization) (World Stroke Organization-Lancet Neurology Commission Stroke Collaboration Group)

See also: Are you aware of the warning signs of a stroke?

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