Stroke in younger adults: The risks and signs

Key takeaways:

  • A stroke can strike anyone anytime — at any age.

  • Stroke risk rises in younger adults who have diabetes or are obese.

  • COVID-19 appears to be causing strokes in younger adults.

  • FAST: Know stroke symptoms and call 911.


One day in February 2019, 35-year-old Nick Dreckman experienced neck pain. He didn’t think much of it and simply adjusted his neck, which was a habit he’d had since childhood. But this time, he suddenly had a dizzy spell afterward. The dizziness got so bad he couldn’t even crawl straight. Even after he stood up, he was hit with severe nausea and had to vomit.

Nick Dreckman was having a stroke.

Fortunately, Nick received the treatment he needed in a Providence emergency department and has since recovered. But his story is a reminder of a sobering fact: A stroke can strike anyone anytime — at any age.

Risk factors for stroke in younger adults

After age 55, the risk for stroke doubles every decade. Most strokes happen in people who are over age 65. However, a recent article from the American Heart Association reports that older adults have seen a drop in the rate of stroke deaths over the past 20 years, which is good news. The less encouraging news is that when it comes to younger adults, their stroke-death rates remain about the same and their rates of non-death-related strokes have gone up.

A recent study found that among patients aged 20 to 54, when looking at high blood pressure or high cholesterol, the incidents of a certain type of stroke varied by sex and race. But when focusing on people with obesity or diabetes, strokes took place across all races and sexes in that younger adult age group.

Some risk factors for stroke can be treated

Risk factors are defined as conditions or behaviors that take place more often in people who already have a disease or who are at risk of getting a disease.

Treatable risk factors for stroke

These are some of the risk factors for stroke that can be helped by working with your doctor and making lifestyle changes.

  • High blood pressure. This is the biggest risk factor for stroke because it increases the risk by two to four times before age 80.
  • Heart disease. Common heart disorders that can cause blood clots that may break loose and lead to stroke include:
    • Coronary artery disease
    • Valve defects
    • Irregular heartbeat (atrial fibrillation)
    • Enlargement of a heart chamber
  • Diabetes. This disease affects more than how the body uses blood sugar (blood glucose). It also causes harmful changes to the blood vessels in the body, including the brain.
  • Cholesterol imbalance. LDL (low-density lipoprotein) cholesterol causes fatty buildup in the carotid artery (atherosclerosis). This causes blood vessels to narrow — leading to heart attack and stroke.
  • Cigarette smoking. This habit has been linked to the buildup of fatty substances (atherosclerosis) in the carotid artery. Blockage in this artery cuts off the blood supply to the brain and causes stroke. The nicotine in cigarettes also raises blood pressure.
  • Lack of exercise and being overweight. Obesity and inactivity are linked to high blood pressure, heart disease and diabetes.

Some risk factors for stroke can’t be medically treated

Some risk factors for a stroke can’t be improved even with medical care or changes in lifestyle. These include:

  • Age. Stroke happens in all age groups.
  • Gender. Men have a higher risk for stroke when young and in middle age, but more women die from stroke.
  • Race. Some ethnic groups have a higher risk of stroke.
  • Family history of stroke. Stroke seems to run in some families.

COVID-19 and strokes in younger adults

A troubling complication of the coronavirus has come to light: Younger adults seem to be suffering from stroke as a result of having COVID-19.

The exact connection still isn’t clear, but it seems to be tied to the virus causing inflammation through the body. This includes the walls of blood vessels, which become inflamed and may react by clumping blood cells together into clots. These clots slow or stop normal blood flow and cause stroke. The longer the brain’s blood flow is stopped, the wider the damage to the brain. When an average person has a large vessel stroke it can cause severe damage.

Testing positive for COVID-19 — even with few or no symptoms — is a surprising reason for the rise of strokes in younger people. It underscores the need for adults in their 20s, 30s and 40s to know the signs of stroke and understand how vital it is to get medical treatment at once.

Know when to get help F.A.S.T. for a stroke

If someone is having a stroke, every second counts to reduce brain damage. Get to know the signs of a stroke with this easy memory device. Think F.A.S.T. and call 911 right away.

Face drooping: Is the person’s smile uneven?

Arm weakness: Is one arm weak or numb?

Speech: Is the person’s speech slurred?

Time to call 911.

Never too young to know the risks and signs of stroke

People who are 20 years old or even 40 years old may think they’re too young for risk factors like high blood pressure or high cholesterol. But that’s not the case. The results can be devastating for anyone who suffers a stroke. Their work, recreation and relationships are affected along with their ability to communicate, their mood, thinking skills for problem-solving and physical abilities. Anyone who survives a stroke will need help to heal and make progress toward a normal life again.

But for younger stroke survivors there’s another layer of help that may be needed for such life experiences as dating, going to school, building a career, pursuing higher-risk physical activities, using advanced technology and even parenting young children.

As the recent study reported, younger people would benefit from regular health screenings sooner, especially for diabetes and high blood pressure. Just as important, awareness about the risks and signs of a stroke is one of the best ways to prevent one or recover from one — no matter what your age.

What are you doing to prevent stroke at your age? Share your thoughts and tips @providence.


Find a doctor

Through Providence Express Care Virtual, you can access a full range of healthcare services. If you need to find a doctor to help you stay healthy and avoid some of the risk factors for stroke, you can use our provider directory or search for one in your area.






Related resources

Get relevant, up-to-date information on the coronavirus (COVID-19) from Providence.

If you need care, don't delay. Learn more about your options.

Patient story: Nick Dreckman, stroke survivor at age 35

Young adults have strokes for the same reason as older adults

Abstract P602: Stroke Risk Factors Among the Young Over Time in the GCNKSS

Are you too young for a stroke? Know the signs and symptoms

What you should know about diabetes: Risk factors, potential complications and screening

Early heart disease detection saves lives

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

About the Author

The Providence Heart & Vascular Team is committed to bringing you many years of expertise and experience to help you understand how to prevent, treat and recover from cardiovascular diseases and conditions. From tips to eating better to exercise and everything in between, our clinical experts know how to help you help your heart.

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