There are common misconceptions about strokes, such as the belief that they only affect older adults or are solely linked to high blood pressure and heart conditions.
In reality, strokes can hit the young too, and not everyone can easily recover from them. Studies indicate that approximately one-third of those who experience a stroke before the age of 50 are not able to live independently or need assistance with everyday tasks.
A recent study by the American Heart Association has found that young adults between 18 and 44 who are long-term tobacco users and have prediabetes are at a threefold higher risk of stroke, even when they do not have high blood pressure and heart-related risk factors.
Age no bar
The study presented at the American Heart Association’s Scientific Sessions 2023 challenges the misconception that strokes only occur in older people and highlight the growing risk among younger adults.
“Young people are usually under the impression that stroke occurs in older individuals — their grandparents’ age. But we are starting to see evidence, such as in this study, that is not the case, strokes are occurring at younger ages,” said Dr Esa M Davis, member of the American Heart Association’s Drug, Alcohol, and Tobacco Committee.
Dr NK Venkataramana, founder, chairman and director of Brains Super Speciality Hospital, Bengaluru, explains that strokes can happen at any age. However, the chance of a stroke increases when certain risk factors come into play. “These risk factors can be categorised as either controllable, allowing for intervention or uncontrollable, beyond our control,” he says.
To identify the biggest risk factors for stroke in young adults, the researchers analysed over one million people from the US hospitals. They looked at young adults who were metabolically healthy, which means they did not have high blood pressure, type 2 diabetes, high cholesterol, or obesity. However, they found that most of them were long-term tobacco users who had trouble reducing their nicotine intake.
Tobacco fuels strokes
About 2 out of every 1,000 young adults admitted to hospitals had prediabetes and were persistent tobacco users. Prediabetes raises fasting blood sugar levels and can progress to type 2 diabetes, increasing the risk of heart issues and stroke. However, making lifestyle changes, like eating healthier, losing weight, and being more active, can help manage and reduce these risks.
To study how tobacco use and prediabetes affect the brain, the researchers compared hospitalised individuals with both conditions to those without them.
The findings showed a higher occurrence of chronic obstructive pulmonary disease—a condition that causes breathing problems—among tobacco users with prediabetes. This group also had a history of prior heart attacks, increasing their risk of future heart issues like attacks, strokes, or heart failure. Moreover, there was a significantly higher chance of being hospitalised for a stroke in this group.
After factoring in variables like age, race, gender, income, and other existing medical conditions, the researchers found that hospitalised individuals who both used tobacco and had prediabetes were three times more likely to be hospitalised for stroke.
Smoke-free way to prevention
The lead author of the study, Advait Vasavada, a resident in family medicine at the University of Nebraska Medical Center in Omaha emphasised the importance of early screening and prevention measures for prediabetes in young tobacco users to reduce their risk of stroke.
“If you are a metabolically healthy, young adult dependent on tobacco use, it is wise to cut down on but better yet eliminate tobacco use completely,” he said in a statement.
“It is also worth noting that having prediabetes can significantly increase your risk of having a stroke at a young age, even if you don’t use tobacco products.”
Davis explained that prediabetes by itself is a major risk factor for cardiovascular disease, and when coupled with tobacco use, it drastically raises the likelihood of having a stroke. “Adding tobacco use dramatically increases the risk of having a stroke, and thus it’s more important to work on efforts to quit tobacco use,” she said in the statement.
The experts say that the single most effective measure people can take to protect their heart health and reduce their risk of stroke is to quit smoking. This becomes even more crucial for those with prediabetes, as it significantly increases the risk of stroke and heart disease at an earlier age.