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By Daniella Gray
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The rate of stroke among younger adults has risen sharply over the past three decades, according to new research, and one especially concerning trend stands out.
The study, published in Neurology, analyzed stroke cases in people aged 20 to 54 from a large, population-based registry in the Greater Cincinnati and Northern Kentucky region between 1993 and 2020.
Young adults today are almost twice as likely to have a stroke as they were three decades ago, the researchers found. In contrast, stroke rates among older adults declined.
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The rise was largely driven by ischemic strokes, which occur when blood flow to the brain is blocked.
Researchers found that ischemic strokes nearly doubled among younger adults between 1993 and 2020.
They also found that traditional stroke risk factors became more common among younger stroke patients over time.
Rates of high blood pressure rose from 47.3 percent to 60.3 percent, diabetes increased from 19.1 percent to 25.5 percent, and atrial fibrillation climbed from 1.4 percent to 5.9 percent.
But one of the most dramatic changes involved substance use.
The proportion of younger stroke patients with documented substance use increased from 4.6 percent in 1993-94 to 40.2 percent in 2020.
Much of that increase was linked to marijuana use, which rose from less than 1 percent of patients to 30.6 percent by 2020.
“Marijuana use has obviously become much more widespread across the United States over the last three decades, and there has been some evidence of a relationship with cardiovascular disease, particularly among those who use it daily,” study co-author David Robinson, a neurologist at the University of Cincinnati, told Newsweek.
He explained that existing studies have limitations and said more rigorous research is needed.
“The stigma around marijuana use is much lower than it used to be, so I think now is the time to start rigorously studying it as a risk factor,” Robinson said. “We don't have all the answers, but its usage has increased dramatically, and we still don't know all the downstream effects.”
The findings suggest young adults should not assume they are too young to worry about stroke risk.
According to Robinson, many key risk factors often go undetected because conditions such as high blood pressure, diabetes and high cholesterol may not cause symptoms early on.
He highlighted the American Heart Association's "Life's Essential Eight" guidance, which includes controlling blood pressure, managing blood sugar and cholesterol, avoiding tobacco, maintaining a healthy weight, staying physically active, eating well and getting adequate sleep.
“Younger individuals are less likely to have a relationship with a primary care provider,” Robinson said. “Coming up with new ways to meet young people where they are is important.”
The researchers also found a modest decline in 30-day death rates among younger stroke patients, suggesting improvements in treatment.
However, they warned that more young adults surviving strokes could increase the long-term burden of disability in the years ahead.
“Younger individuals are also much more likely to go to urgent care centers, and it is important to think about how we can identify high-risk patients even in these more episodic care settings,” Robinson said.
Reference
Fisher ER, Ding L, Stanton RJ, et al. Stroke in the Young: Incidence, 30-Day Case Fatality Rates, and Risk Factors Over Time in a Population-Based Study. Neurology. 2026;107(8):e218622. Doi:10.1212/WNL.0000000000218622
Newsweek’s reporters and editors used Martyn, our AI assistant, to produce this story. Learn more about Martyn here.
Contact Newsweek editors on this story: Kara Doleman and Gray R. Thomas
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