June 2, 2020 by John Fernandez
Stroke Questions Answered: Why are Rates Rising in Younger Adults and What About Prevention?
Stroke is the No. 5 cause of death for adults in the United States and the No. 1 cause of disability, according to the American Stroke Association.
But while strokes have been generally associated with older adults, a troubling trend has emerged: Rates of stroke in adults younger than 55 have been on the rise. The recent stroke-related deaths of actor Luke Perry and film director John Singleton, both in their early 50s, have put a fresh spotlight on preventative measures that young people can take to diminish or avoid risk factors.
During a recent Facebook Live session, Baptist Health stroke experts answered questions about strokes, including the latest trends, symptoms, and lifestyle modifications you can make to help prevent high blood pressure and other risk factors.
The featured guests: Felipe De Los Rios, M.D., medical director, stroke program at Baptist Health Neuroscience Center, and Daniel D’Amour, R.N., stroke program manager at Baptist Health Neuroscience Center. Here are some of the questions and answers from the Facebook Live in Part I of our recap as we help mark National Stroke Awareness Month.
Question: What is happening in someone’s brain when they’re having a stroke?
Dr. De Los Rios:
“Generally, a stroke happens when there’s lack of blood flow to an area of the brain. So the brain basically starts to stop functioning because the brain cells are not getting the energy to function and you lose whatever that area is supposed to be doing. The brain normally allows us to do things like talking, just understanding language and vision. All of this is through the brain. So you might have weakness of an arm, weakness of a leg, difficulty speaking, not seeing very well, and not feeling very well. And it usually starts abruptly. So you’re fine — and then all of a sudden, you’re not fine.”
Question: Are strokes equally common in men and women, and are there any minority groups that are more affected?
“Women actually have a little bit higher incidence. But we really can’t pinpoint why this is. A lot of people think that it’s simply because women live longer and they’re going to have a higher chance of having a stroke throughout a lifetime. Stroke is very much age-related. Although you can have a stroke at any age, the older you get, the more chance you have of anything — heart attack, stroke, diabetes — with age.”
Question: There have been news reports of very high-profile deaths of younger people who suffered strokes — actor Luke Perry, who was only 52 years old, and 51-year-old film director John Singleton. They seemed very young to be having a stroke. Is this a trend and why might it be happening?
Dr. De Los Rios:
“About 10 percent of strokes are happening in adults younger than 50. And we’ve seen that this trend is increasing. When we look at hospital admission data and some incident rates from population-based studies, it seems like over the last decade or so you, this (rate of strokes in people under 50) might have even doubled.”
Question: That is a significant trend. Are we talking about high blood pressure and other lifestyle-related risk factors when it comes to younger stroke victims?
“As we progress through the generations, it’s pretty clear that our activity level is way less than it was years ago. I’m in my 50s and I can remember growing up — always being outside, chasing dogs, throwing baseballs, and all that kind of stuff. I don’t think that’s quite as common today. We have gone away from playing outside. Schools have reduced recess time. Physical activity is very important. The more active you are and the more engaged we are in physical fitness, the more that you are going to reduce your reduce your risk (of stroke), as opposed to increasing your risk (with a sedentary lifestyle).
Dr. De Los Rios:
“We think that’s one of the key drivers (lack of physical activity). We don’t know for sure, but it does seem so. And some of these studies have also shown that we see the risk factors for stroke and heart attack, which are very similar, start happening earlier in life. So that might have something to with it (young stroke victims). There’s also a relationship between substance abuse and stroke, and that’s something that societies have been battling. And we have epidemics such as the opioid crisis and there’s drugs like cocaine and amphetamines. And even some other medications that you wouldn’t necessarily intuitively think that could be related to stroke, like for example some weight loss medications, that can also increase the risk of stroke.”
Question: What about everyday “drugs” that, unfortunately, many Americans use such as alcohol and tobacco. What are their connection to strokes?
“Smoking, as we know, is not only a risk for stroke but it’s also a risk for heart attack. Smoking plays a really bad part as to the viscosity of the blood itself and how available your arteries are to expand and contract like they’re supposed to do. But those (alcohol and tobacco) are kind of like beating up on your arteries from the inside out.”
Question: Is that what high blood pressure is doing to arteries?
Dr. De Los Rios:
“That’s part of the problem because high blood pressure, especially during early phases, doesn’t cause much symptoms. So people can live a long time with their blood pressure being high, and not realizing it unless you go for your regular medical check-up. I know that this is a very simple analogy, but it’s like having the pressure high on your house and then you know the pipes start bursting and things stop working as there’s more wear and tear on those conduits. Over time, high blood pressure does more wear and tear. It predisposes the arteries to either block off the smaller ones, or develop fatty buildup on them. And so if you’re able to control those risk factors when you’re young, or at middle age, you definitely have a much healthier later life. So it’s never too late to start, but it definitely benefits you the most when you control it from a young age.”