In the United States, nearly 800,000 people have a stroke each year. Stroke is the third most common cause of death in the US and is the top cause of disability. But while almost three-quarters of stroke victims are over 65, the number of young people (under 45) who are having strokes and suffering serious consequences is rising. The theories behind this distressing increase abound, from hormonal birth control use and smoking to the rising prevalence of lipid disorders and diabetes.

What is a stroke?

When someone has a stroke — whether they’re 35 or 75 — normal blood flow to the brain is interrupted. Usually, the cause of the blood flow interruption is a blocked artery or a broken blood vessel that causes bleeding into the brain tissue. Blood transfers oxygen to the brain, so when blood flow is cut off, it doesn’t take long for brain cells to start to die, causing a range of drastic consequences.

Regardless of the age of the stroke victim, consequences can vary in severity depending on the length of the stroke and the part of the brain in which it occurred. Many stroke victims suffer from weakness and paralysis post-stroke because their brains have to re-learn how to move that specific part of their body all over again. Over two-thirds of people who have strokes suffer some type of disability afterward.

There is about one stroke every four minutes in the United States, and even if you don’t personally know anyone who has suffered a stroke, you’ve probably heard of some of the celebrities who have recently passed away due to stroke. In March 2019, Luke PerryBeverly Hills 90210 star, died of a stroke at the age of 52. Actor Bill McCoy of Titanic and Big Love fame also passed away because of a stroke, along with politician Winston Churchill and dashing leading man Cary Grant.

Why are more young people having strokes?

Stroke numbers in older populations are actually decreasing, but stroke rates for people under 45 have significantly increased since 2003. Behaviors like smoking and using hormonal birth control (for women) frequently get the blame, but scientists are now saying that these two risk factors aren’t big enough or prevalent enough to account for such a large uptick in young-person strokes.

Instead, the current theory is that the increased number of young people with hypertension, diabetes, high cholesterol, and obesity is leading to a larger number of stroke victims. And although many more people are living with and dealing with added risk factors (like all of the above, as well as smoking, drug use, and heart disease), there is still a lack of awareness among younger populations about the causes and consequences of strokes. Older people have seen stroke rates decrease in recent years, presumably not because they aren’t suffering from diabetes or high cholesterol but because they are aware of their stroke risks and are taking steps to prevent and monitor symptoms. Young people, on the other hand, are more likely to not even think about their cholesterol rates, their blood pressure, or the possibility of stroke.

It is also possible that the signs and symptoms of strokes are different in people under 65. In most strokes (at least as far as the medical field is aware), the warning signs can be summed up with the acronym FAST: Facial drooping, Arm weakness, and Speech difficulties (so it’s Time to call 911). But what if the symptoms of a stroke are different in younger people? Dr. Greene-Chandlos, a stroke specialist, says that because older adults have bigger blood vessels the signs of a stroke tend to be bigger: speech that is difficult to understand, big facial drooping, etc. But since blood vessels in younger people are smaller, it is possible that a blood clot could cause problems in other parts of the body, leading to many different types of symptoms. Signs of stroke that are just beginning to be recognized are numbness (without associated tingling or pain), debilitating headaches, and even extreme cases of hiccups.

What can be done to prevent strokes?

The first, best, and most important way to prevent a stroke in a person of any age is to get your cholesterol levels and blood pressure checked routinely. Additionally, being aware of the risk factors can not only lead you to change habits but to also be on the lookout for stroke warning signs. Some risk factors, such as previously having a stroke, heart disease, and diabetes aren’t necessarily changeable. However, reversing risk factors such as smoking, heavy alcohol use, and physical inactivity can drastically decrease your potential for having a stroke. Dr. Greene-Chadlos recommends that everyone, regardless of age, get regular wellness checks and get in tune with their bodies and their health levels and numbers. Knowing what the risk factors are and knowing if you are at higher risk of stroke is half of the battle: if you know that you are at risk and start having symptoms of a stroke (even if they are unusual, like a headache), you’ll be more likely to quickly get the help you need.

While the rising stroke numbers are certainly concerning, the story doesn’t have to end there: learn the risk factors, take care of yourself, and know the warning signs. Strokes are common, terrifying things, but with a little bit of knowledge, you can prevent a stroke from happening to you.