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Why People in Their 50s Should Understand Stroke Symptoms and Risk

Most people, including doctors, associate it with older adults

By Debbie Koenig

The big statistic most of us hear about stroke is that our risk doubles every decade after age 55. But earlier this year, actor Luke Perry and director John Singleton died of stroke. Perry was 52, Singleton just 51.

Credit: Adobe

Last year, Olympic sprinter Michael Johnson — once known as “the fastest man in the world”— survived a stroke at age 50. So, it appears waiting until age 55 to think about stroke could be deadly.

Are More Midlife Adults Having Strokes?

A 2017 study by researchers at the University of Michigan and the Veterans Affairs Healthcare System’s Department of Neurology in Ann Arbor, Mich., found that among people age 45 to 54, the rate of hospitalization for the most common type of stroke rose more than 20% from 2003 to 2012.

But the study’s finding doesn’t necessarily mean that more people are having strokes younger, says Dr. Koto Ishida, medical director at the New York University Langone’s Comprehensive Stroke Center. “Rates aren’t necessarily increasing, but awareness is,” she says.

About 80% of first-time stroke victims of any age have high blood pressure.

In 2003, the American Stroke Association launched a warning signs awareness campaign. With increased awareness, more potential stroke victims know to seek help sooner.

Also, Ishida says, diagnostic methods changed during the Michigan study’s time period, so some 2012 stroke victims might have been classified as something else in 2003.

One thing that does seem to be happening in people at younger ages: more risk factors for stroke, including obesity, high blood pressure, elevated cholesterol, coronary artery disease and diabetes. The Michigan study found that the number of stroke victims age 45 to 54 with three to five risk factors rose by more than 70%.

“We’re definitely seeing these risk factors younger,” says Ishida. “We call many of them ‘silent killers.’ A lot of people come to us in their forties and fifties believing they were healthy until now. But you could’ve had high blood pressure for ten years and not known it.” About 80% of first-time stroke victims of any age have high blood pressure.

Stroke Risk and Prevention

Because risk factors like high blood pressure or cholesterol don’t show symptoms until something like a stroke hits, an annual physical exam is the most important thing people can do to prevent one, Ishida says. That gives your doctor the chance to monitor you and help you lower elevated blood pressure or cholesterol to a less risky level.

There are some risk factors that you can’t change, however, like your family history. “Younger strokes and younger risk factors run in families,” Ishida says, adding that you should tell your doctor if younger people in your family have died of stroke, so they will know to start screening you sooner.

Race also matters when it comes to stroke: The risk of stroke among blacks is nearly twice as high as for whites, and blacks tend to have strokes younger.

Gender is another factor: The Michigan study found that among people age 45 to 54, nearly 30% more men than women were hospitalized for stroke.

But the good news is, up to 80% of strokes in the U.S. are preventable, according to the Centers for Disease Control and Prevention (CDC). These lifestyle changes can lower your risk of stroke:

  • Quit smoking. Smokers are two to four times more likely than non-smokers to have a stroke.
  • Lose weight. Obesity increases your risk for high blood pressure, diabetes and other key risk factors for stroke.
  • Drink less alcohol. It can raise your blood pressure. The CDC recommends men have no more than two drinks a day, and women just one.

'BE FAST' Could Save a Life


Stroke is the fifth-leading cause of death in the U.S., but far more people survive stroke than die of it. As many as nine out of 10 survivors have some paralysis immediately after.

Thanks to medical advances in emergency treatment, recognizing a stroke immediately could make the difference between a full recovery and decades of living with a stroke-related disability. But for people under 55, stroke isn’t often top of mind.

“Every minute when you have complete blockage of blood flow to the brain, two million brain cells are irreversibly killed,” Ishida says. “If you wait and come in the next morning, it takes treatments off the table.”

The sudden onset of symptoms is a hallmark of stroke — there aren’t a lot of other things that happen so quickly, says Ishida. A sudden severe headache can be a symptom, but otherwise there usually isn’t much pain. “That’s a downside for us in the stroke world,” Ishida says. “Pain is a good motivator to get people to the ER.”

The American Stroke Association and National Stroke Association both suggest the acronym “FAST” to help you remember the key symptoms of stroke:

  • Face: Try to smile. Is one side droopy?
  • Arms: Lift both arms. Is one side weaker than the other?
  • Speech: Are you having trouble getting words out, slurring or having difficulty understanding others?
  • Time: Get treatment as quickly as possible. If the answer is Yes to any of the above questions, call 911 immediately.

While FAST is handy, it’s far from complete. Ishida likes to add the word BE before FAST to cover more possible signs:

  • Balance: Are you feeling dizzy or struggling to keep your body steady?
  • Eyes: Do you have a sudden problem with one or both eyes or double vision?

Whatever you do, don’t attempt to treat symptoms yourself. The two primary types of stroke have identical symptoms but do virtually opposite things to your brain.

The most common type, ischemic, happens when a blood clot cuts off blood flow to your brain.

Hemorrhagic strokes happen when a weakened blood vessel ruptures and blood floods into surrounding brain tissue. Since you don’t know what type of stroke you’re facing, guessing at treatment could be catastrophic.

Bottom line, says Ishida: “If you’re having sudden onset of one of those symptoms, stroke should be top of mind, no matter your age.”

Debbie Koenig Debbie Koenig is a writer and the author of the cookbook Parents Need to Eat Too: Nap-Friendly Recipes, One-Handed Meals & Time-Saving Kitchen Tricks for New Parents. She lives in Queens with her family. Read More
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