Stroke incidence climbed sharply among younger adults over nearly three decades, according to a study examining first strokes in people ages 20 to 54. Researchers described the increase as more than a doubling among young adults.

The University of Cincinnati researchers analyzed 2,076 first strokes recorded in the Greater Cincinnati and Northern Kentucky region. The data covered periods beginning in 1993 and 1994 and continuing through 2020.

During that span, annual stroke incidence rose from about 34 to 62 cases per 100,000 people. The increase was driven primarily by ischemic stroke, which occurs when a blood vessel supplying the brain becomes blocked.

Researchers also documented increases in hypertension, diabetes, atrial fibrillation and substance use among younger adults who experienced strokes. Atrial fibrillation is an irregular heartbeat.

David J. Robinson, M.D., an assistant professor of clinical neurology and rehabilitation medicine at the University of Cincinnati College of Medicine, warned about the potential consequences. “This has major implications, since young people who develop disability from a stroke may no longer be able to work or provide for their families,” he told Fox News Digital.

Robinson, a study coauthor, said researchers do not yet know with certainty why strokes are becoming more common. He said the trend needs deeper study if researchers hope to reverse it.

Documented substance use rose particularly sharply, increasing from 4.6% to 40.2% during the study period, primarily involving marijuana. Researchers could not determine whether that increase was responsible for any portion of the rise in strokes.

Robinson said there is a relationship between marijuana use and stroke, but most existing evidence involves heavier use. He added that the relationship between marijuana use and cardiovascular disease requires more study so patients can receive appropriate advice.

The pattern among younger adults contrasted with what researchers observed in older people. Stroke incidence among older adults declined from about 619 to 453 cases per 100,000 people each year.

Short term survival also improved among younger stroke patients. The proportion who died within 30 days declined from 11.7% to 9.4%, with the improvement occurring primarily in bleeding related strokes, including intracerebral and subarachnoid hemorrhages.

“Our study might provide evidence that we have gotten better at treating people who have hemorrhagic strokes and helping them survive, which is encouraging,” Robinson said. “Still, prevention is the most important thing to focus on, because just surviving a stroke doesn't mean you aren't left without disability.”

The findings were published in the journal Neurology on Sept. 23. Dr. Jason A. Gluck, vice chair of the Heart & Vascular Institute and system chief of cardiology at AtlantiCare in New Jersey, was not involved in the research.

Gluck emphasized that stroke remains uncommon among younger adults, but their risk is not zero. He said the troubling finding is that stroke rates are moving in the wrong direction for the younger population.

Many stroke risk factors can be identified and treated before an event occurs, Gluck said, although younger people may not know they have them. He identified high blood pressure, diabetes, smoking, obesity, abnormal cholesterol and activity among factors that can contribute to stroke.

“Vascular disease doesn't suddenly begin when you're 65; it develops over time,” Gluck said. Robinson similarly emphasized hypertension as the risk factor most closely associated with stroke and called for ways to improve screening among younger people.

The study had important limitations, including the absence of comparable risk factor data for people who did not experience strokes. That made it difficult for researchers to determine what was causing the rising incidence.

Changes in medical documentation and diagnostic methods over nearly three decades may also have affected the findings. Increased MRI use could have improved stroke detection, while greater documentation or disclosure could have contributed to the recorded rise in substance use.

The research was geographically limited to five counties in one U.S. state. Robinson said additional studies will be needed to understand why the trend is occurring.

For prevention, Robinson cited blood pressure control, better eating, less sedentary behavior, quitting tobacco products, sufficient sleep, weight management, cholesterol control and blood sugar management. Gluck advised calling 911 rather than driving to the hospital when stroke symptoms appear.

Gluck also recommended the “BE FAST” guide for recognizing a possible stroke. The source identified “E” as eyes or vision changes, including suddenly being unable to see normally, and Gluck stressed the importance of acting quickly.