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A recent Rutgers analysis shows that stroke death rates will rise among millennials as they get older, reversing a 40-year decline. Westend61/Getty Images
  • A recent analysis shows that stroke fatalities will rise among millennials, reversing a 40-year decline.
  • Researchers suggest that increased stroke-related deaths may be attributed to obesity and diabetes.
  • Some experts attribute the rise in deaths to a lack of access to preventive healthcare.
  • Lifestyle is also a contributing factor to the rise in stroke fatalities among younger generations.
  • Many stroke risk factors are modifiable with healthier dietary and lifestyle choices.

Stroke is a leading cause of death and disability in the United States, with more than 795,000 people experiencing a stroke each year.

A recent analysis from researchers at Rutgers University shows that stroke death rates in the U.S. decreased from 1975 to 2019, but that trend is expected to change for millennials as they get older.

According to researchers, stroke fatalities will rise among millennials compared to prior generations.

The analysis was published in the International Journal of Epidemiology.

The Rutgers analysis was the first to separate patients by birth year and identify the rise in age-adjusted ischemic stroke risk among people ages 18 to 84 in the U.S. between 1975 and 2019.

“Starting around 1960, the later you were born, the higher your risk of suffering a fatal ischemic stroke at any particular age,” Cande Ananth, PhD, MPH, lead author of the study and chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School, said in a news release.

“This study didn’t identify a cause for this trend, but other research suggests the main culprits are increasing rates of obesity and diabetes,” Ananth continued.

Researchers also discovered that stroke fatality rates dropped more for ischemic strokes (80%) compared to hemorrhagic strokes (65%).

Another important finding was the disparity between male and female stroke fatality rates, which diminished as patient age went up.

Men 55 years of age are more than twice as likely to have a stroke that results in death compared to women. However, the rates of fatal stroke are nearly the same at 85 years of age.

Stroke death rates may be increasing due to a lack of focus on stroke and heart attack prevention.

“As a healthcare system and as a community, we focus more on intervening when people are sick and less on preventing dangerous diseases such as stroke,” Dr. Atif Zafar, a telestroke neurologist and medical director of the stroke program at St. Michael’s Hospital in Toronto, Canada, told Healthline.

“The results [of the Rutgers analysis] do not surprise many of us stroke physicians. Our preventive healthcare side is very weak, and what we are seeing is a result of this dilemma.”

The primary preventive healthcare is outdated, Zafar noted, which is affecting access for younger generations.

Lifestyle is also a contributing factor to the increase in stroke-related deaths. Research has shown that increasing rates of obesity and diabetes also play a role.

“When you have a higher prevalence of obesity and diabetes in the youth, the chances of stroke-related disability and death would go up,” Zafar said.

Incidences of stroke have been on the rise among young people in recent years — but death from stroke is rare among younger age groups. As the Rutgers analysis indicates, stroke mortality begins to increase as people get older.

In an interview with Healthline, Ananth said that due to the observational nature of the Rutgers analysis, the study was not designed to examine risk factors among millennials — though they should still be considered.

“There are a multitude of risk factors (including high BMI and obesity, smoking, and alcohol use, diabetes and hypertension being the most important) that predispose a person to increased risk of stroke deaths,” Ananth said.

What’s more, according to Zafar, is that millennials may not always get the medical care they need.

Prior research has shown that only 65% of millennials have a primary care doctor, compared to 82% of baby boomers and 74% of generation Xers.

Millennials may also face different challenges compared to past generations.

“As life and work [have] become more demanding due to technology and the increasing efficiency in the world, millennials have less time for themselves, and hence their personal health is being compromised,” Zafar said.

Ananth noted that stress is a likely contributor to the increase in stroke-related deaths among millennials.

Still, more research is needed to determine whether new stressors resulting from a changing world should be considered potential risks.

“The extent to which air pollution and climate change may have impacted risks remain poorly understood,” Ananth said.

Not all risk factors for stroke are preventable, but healthy lifestyle choices can help minimize stroke-related deaths.

“While race, gender, and genetic predisposition are contributors to some of these cases, the far more common risk factors are lifestyle-based for both types of strokes (ischemic and hemorrhagic), which include high blood pressure, diabetes, smoking, obesity, and lack of physical activity,” Dr. Chirag Gandhi, director of the Brain and Spine Institute at Westchester Medical Center and the NovaSignal Scientific Advisory Board, told Healthline.

Combining healthier food choices with regular physical activity and maintaining close communication with a physician can help minimize stroke risk, Gandhi said. Your doctor can track key laboratory values and initiate medications as needed.

Advancements in technology can also aid in prevention.

“Technology is essential in the care of stroke patients during the critical phase of care in the ICU and important follow-up care in the outpatient setting,” Gandhi noted.

“Implementation of automated transcranial dopplers [ultrasound] now allows our ICU team to more closely understand the real-time health of blood vessels in the brain and watch for any rapidly evolving new clots in the brain after stroke.”

As such, healthcare teams can rapidly augment care for people who experienced brain injury from stroke, Gandhi explained.

Ultrasound technology allows doctors to accurately detect pathways of clot migration through the heart and into the brain. Once identified, these abnormal pathways can be effectively closed, reducing the risk for future stroke, Gandhi said.

According to a recent analysis, researchers predict the number of stroke fatalities will rise for the first time in 40 years among millennials.

The increasing number of stroke fatalities among this cohort may be due to an increase in obesity and diabetes, a lack of access to medical care, and, possibly, the unique stressors of modern life.

To lower the risk of stroke, weight management, following a healthy, balanced diet, and keeping blood sugar and blood pressure under control are effective tactics. Stress management is also key.