Why More Young Adults Are Experiencing Strokes

September 03, 2025

A female medical professional checking a male patient's blood pressure in an examination room

While strokes are often associated with older adults, younger people are experiencing them more frequently. New data shows that strokes increased nearly 15 percent in people ages 18 – 44 in the last decade.

“The increase in strokes corresponds with a rise in cardiovascular risks among younger adults,” says University Hospitals Department of Neurology chair Cathy Sila, MD, a stroke specialist. “With guidelines recommending more aggressive preventive care of monitoring and treatment, we don’t want to miss this opportunity for preventing strokes and other vascular events.”

Managing Stroke Risk

Most strokes are caused by blockage in a blood vessel that interferes with blood flow to the brain – just like a heart attack is caused by blockage of blood flow to the heart. Lifestyle plays an important role in a person’s risk of stroke and heart attack.

“Eighty to ninety percent of all strokes are related to a risk factor that can be managed,” says Dr. Sila. “The recent trend underscores the importance for younger adults to identify and modify any risk factors as early as possible.” Those risks include:

High blood pressure
High cholesterol
Diabetes
Smoking
Obesity
Physical inactivity
Alcohol abuse

“A prevention plan includes educating our patients about health risks and care to regularly monitor their health, such as basic lab work, physical examination and understanding family history,” Dr. Sila says.

Other Factors to Consider

Additional factors may also be playing a role in the rise in strokes in younger adults:

The opioid epidemic. Recreational drug use has significant implications for heart attack and stroke, Dr. Sila says. Particularly risky are injected drugs, cocaine, opioids such as heroin and certain amphetamines. Many drugs can cause high blood pressure, spasms and blockages in arteries, arrhythmias and heart muscle disease.
ADHD medications. Research has shown an increased risk of cardiomyopathy, a heart muscle disease, associated with stimulant medication use in young adults with attention-deficit/hyperactivity disorder (ADHD). Cardiomyopathy increases risk of stroke and other cardiovascular complications.
Energy drinks. Energy drinks have been linked to an increase in atrial fibrillation (AFib) in young adults. AFib is a heart rhythm disorder that can trigger a stroke.
Stress. Chronic stress can raise the risk of stroke and heart disease. A recent study found a link between chronic stress and stroke risk in women 18 to 49 years old. Chronic stress can elevate blood pressure and cause inflammation in the body that harms the cardiovascular system. Dealing with stress by smoking, drinking too much or eating too much comfort food will compound risks of cardiovascular disease.

“We all have emotional stresses, but how do we address those?” Dr. Sila says. “It’s about recognizing stress and the unhealthy behaviors it triggers for you, and changing those behaviors to manage stress in a healthy way.”

Better Stroke Detection

Dr. Sila says better detection may play a part in the increase in stroke diagnoses in young adults. The growing use of MRI to diagnose stroke has improved detection, as the technology is more accurate and can pinpoint tiny abnormalities better than a CT scan.

“We’re using MRI scans more and more, which are extremely sensitive and specific for diagnosing a stroke and finding small things we might have missed on CT scan,” Dr. Sila says. “Improved technology is improving the diagnosis. Perhaps some people with stroke symptoms might have otherwise been misclassified as uncontrolled diabetes, migraine or other things.”

Hope for the Future

Better detection of stroke and earlier diagnosis of conditions that increase stroke risk are hopeful developments for reducing the increase in young adults. The revolution of weight-loss drugs known as GLP-1 receptor agonists is also promising. These drugs, such as Wegovy and Ozempic, have been shown to reduce cardiovascular risk, Dr. Sila says.

“Ultimately, the best way to prevent a stroke is with a healthy diet, exercise, an ideal body weight, restorative sleep and seeing a primary care doctor to identify risk factors they can help you manage. You’re never too young to start.”