Why Is Stroke Risk Rising Among People Under 65?

Stroke is still much more common among older adults. But an important trend has emerged: stroke has been increasing among younger and middle-aged adults while remaining relatively stable among people 65 and older.

According to the CDC, stroke prevalence increased from 2011–2013 to 2020–2022 by:

• 14.6% among adults ages 18–44
• 15.7% among adults ages 45–64

So what’s driving the increase?

High blood pressure is a major part of the story

High blood pressure is one of the most important risk factors for stroke — and it often causes no symptoms.

The CDC has identified rising rates of high blood pressure, obesity and diabetes as possible contributors to the increase in stroke among younger adults.

These conditions can damage blood vessels over many years. They don’t suddenly become dangerous when someone turns 65.

Smoking, physical inactivity and an unhealthy diet can also contribute to several of these risk factors.

Younger stroke patients can have different risk factors

Traditional cardiovascular risk factors aren’t the whole story.

Research has found that among younger adults who experience a stroke, conditions such as migraine, blood-clotting disorders, kidney disease, autoimmune disease and cancer can also be associated with stroke.

These factors appear to be particularly important among the youngest stroke patients.

That doesn’t mean, for example, that having migraines means you’re likely to have a stroke. It means migraine was more common among younger people who experienced stroke in the study.

The causes change with age

A 25-year-old who has a stroke can have a very different set of risk factors from a 55-year-old.

In the youngest adults, less traditional factors can play a larger role. As people move into middle age, conventional cardiovascular risks — particularly high blood pressure — become increasingly important.

Researchers also caution that improved detection and diagnosis may account for some of the increase, but it doesn’t appear to explain the entire trend.

Why this matters

The important lesson isn’t that everyone under 65 should be worried about having a stroke.

It’s that stroke prevention shouldn’t wait until old age.

Blood pressure, cholesterol, blood sugar, smoking, physical activity and diet can all affect cardiovascular health years before a stroke occurs. Many of the biggest risk factors can be identified before symptoms appear.

The Watchdog Takeaway

Stroke is still primarily a disease of older adults, but it’s becoming more common among people under 65.

There isn’t one explanation. Rising rates of high blood pressure, obesity and diabetes appear to be part of the story, while younger stroke patients can also have less familiar risk factors such as migraine and blood-clotting disorders.

The practical message is simple: stroke prevention shouldn’t wait until old age.