Stroke rates are climbing at an alarming rate globally. But this increased risk isn’t impacting everyone in the U.S. equally.

Over the past 2 decades, there’s been a decline in the number of strokes for Americans over the age of 75. Yet overall, people are about 60% more likely to have a stroke. The reason: People under 50 are having more strokes than ever. That’s according to data presented in February at the conference for the American Stroke Association.

It’s a shocking trend. In the U.S. today, someone dies of a stroke every 4 minutes. And the problem is worse for people in certain parts of the South and Midwest — namely, Alabama, Arkansas, Minnesota and North Dakota.

So what’s going on here? And how worried should you be?

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To learn more about the risk of stroke, keep reading.

Why strokes happen

A stroke occurs when a blood clot blocks the blood supply to part of the brain or when a blood vessel in the brain bursts. (The former, known as ischemic stroke, is much more common.) In either case, brain cells begin to die within minutes due to a lack of oxygen.

The drop in stroke rates among older adults is great news. The cause may simply be that doctors are getting better at identifying and treating risk factors. In other words, they may be stopping strokes before they happen, says Alon Gitig, MD. He’s the director of cardiology at Mount Sinai Doctors-Westchester in Scarsdale, New York. Lowering blood pressure and blood sugar levels, for instance, can reduce a person’s risk of stroke.

So then why are people under 50 having more strokes? Dr. Gitig points to the rise in obesity, prediabetes, metabolic syndrome and insulin resistance in younger folks. These conditions raise the risk of high blood pressure, Type 2 diabetes and elevated cholesterol — all of which can make a stroke more likely, he points out.

Recommended reading: Your guide to anti-obesity weight loss medications

Stroke symptoms to look for

When it comes to a stroke, time is of the essence, says Nieca Goldberg, MD. She’s medical director of Atria New York City and a clinical associate professor of medicine at NYU Grossman School of Medicine. If you react fast, you can reduce the risk of brain damage.

According to the Centers for Disease Control and Prevention (CDC), there are a handful of symptoms that point to a stroke. If you notice any of these signs, you should call 911 immediately:

  • Sudden numbness or weakness in the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or difficulty understanding
  • Trouble seeing in 1 or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

For an easy way to tell whether you or someone else might be having a stroke, the CDC recommends the F.A.S.T. test:

Face: Does one side of your face droop when you smile?

Arms: When you raise both arms, does one drift downward?

Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

Time: See any of the above? Call 911 immediately.

If you’re experiencing a stroke, it’s vital that you take an ambulance, stresses Dr. Goldberg. (About 1 in 3 stroke patients don’t, according to the CDC.) Emergency workers can alert the hospital that a stroke patient is coming. This way, the hospital’s stroke team can be ready as soon as the patient arrives.

The ambulance may also take you directly to a specialized stroke center. More than 90% of Americans live within an hour of a stroke center facility, according to a recent study in JAMA Network Open.

How to prevent a stroke

“One of the best ways to reduce the risk of stroke, especially at a young age, is to lead a healthy lifestyle,” says Dr. Goldberg. The goal is to become more self-aware and make changes that last. So start with small tweaks that’ll add up over time.

Watch what you eat

The CDC recommends filling your plate with foods that are low in saturated fat and high in fiber. Think: fruits, veggies, whole grains, low-fat dairy and healthy sources of fat such as nuts and olive oil.

As much as possible, limit your salt intake to lower blood pressure. “When eating out, always ask for sauces on the side, since they tend to be loaded with sodium,” says Dr. Goldberg. These efforts can help lower your blood pressure and cholesterol, both risk factors for stroke. (For more on eating for heart health, check out this simple guide to the DASH diet.)

Be aware of waistline creep

Excess weight puts more strain on your heart and impedes blood flow. It can also cause your metabolism to not work as it should.

Having excess weight doesn’t guarantee that you’ll develop a chronic disease. But it does raise your risk of health conditions such as high blood pressure and high cholesterol, says Dr. Goldberg. That explains why people with excess weight or obesity have more than twice the risk of developing heart disease or Type 2 diabetes, or having a stroke, according to research published in The Lancet.

When in doubt, ask your doctor what you can do to maintain your weight over time. That might involve reviewing your medications. (Some can have weight gain as a side effect.)

Get a little exercise every day

Movement not only helps keep your weight in check — it lowers your cholesterol and blood pressure levels, too. And you don’t have to run marathons. The National Institutes of Health recommends 150 to 300 minutes of moderate-intensity exercise per week. You can hit that with a 30-minute walk every day.

While you’re at it, try to add short bouts of movement to your normal routine. (Here’s how your health improves every time you take the stairs.)

Check your vices

Cigarettes greatly raise the risk of a stroke. (Here’s how these 4 people quit smoking for good.) And too much alcohol raises your blood pressure. Men should have no more than 2 drinks per day, and women no more than 1, according to the CDC.

Getting these habits under control can have a big impact on your stroke risk and overall health. But even if you’re doing everything right, you may still need medication to help you manage a chronic disease. And Optum Perks wants to help. Download our mobile app to find and save prescription coupons from your phone.

Additional sources

Global stroke rates are on the rise: International Journal of Stroke (2022). “World Stroke Organization (WSO): Global stroke fact sheet 2022

U.S. stroke rates: American Heart Association

Stroke overview: Centers for Disease Control and Prevention

Obesity facts: Centers for Disease Control and Prevention

Stroke symptoms: Centers for Disease Control and Prevention

91% of Americans live within an hour of a stroke center: JAMA Network Open (2022). “Estimated population access to acute stroke and telestroke centers in the US, 2019”

Weight and stroke risk: The Lancet (2017). “Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe

Exercise recommendations: JAMA (2018). “The physical activity guidelines for Americans