Younger adults under the age of 50 may face a higher risk of stroke from less common causes like migraines and other medical conditions, rather than from well-known risks such as high blood pressure or smoking.
This is the finding of a new study published in the journal Stroke, from the American Stroke Association.
Doctors have known that ischemic strokes, which are caused by blood clots, are becoming more common in adults aged 18 to 49. Many of these strokes have no clear cause, which makes them harder to prevent.
These types of strokes are known as “cryptogenic strokes.” While traditional risk factors like high blood pressure, obesity, or diabetes explain many strokes in older adults, younger adults often suffer strokes without showing these usual warning signs.
Dr. Jukka Putaala from Helsinki University Hospital led a research team to better understand what puts young adults at risk for stroke. His team studied health data from over 1,000 adults in Europe between 18 and 49 years old, with a median age of 41. Half of them had already experienced a stroke, while the other half had not.
The study looked at 12 common stroke risk factors, such as high blood pressure and cholesterol; 10 less common factors, such as migraines with aura, kidney disease, or cancer; and five risk factors that apply only to women, like pregnancy-related conditions.
They also focused on a heart condition called patent foramen ovale (PFO), which is a small hole in the heart that is usually harmless but may increase stroke risk.
The results showed that traditional risk factors were more linked to strokes in people without a PFO. In contrast, those with a PFO were more likely to have strokes caused by nontraditional risk factors, like migraines with aura or blood clots in veins.
Among people with no PFO, each additional traditional risk factor increased the chance of stroke by 41%, while each nontraditional factor increased it by 70%. Female-specific risk factors also raised stroke risk by 70%.
Among those with a PFO, traditional risk factors raised stroke risk by only 18%, while nontraditional ones more than doubled the risk. One of the most surprising findings was that migraines with aura were a major cause of strokes in younger adults. For people with a PFO, migraines were linked to nearly half of the unexplained strokes.
The researchers also studied how much each type of risk factor contributed to the total number of strokes. Among people without a PFO, traditional factors were responsible for about 65% of strokes, nontraditional ones for 27%, and female-specific factors for 19%.
But in people with a PFO, nontraditional factors were responsible for almost half of the strokes, showing just how important they are in these cases.
This research highlights the need for doctors to pay more attention to nontraditional stroke risks, especially in young adults and women. Dr. Putaala recommends doctors routinely ask younger patients about migraines and other conditions not typically linked to stroke.
Dr. Tracy Madsen from the University of Vermont, who was not part of the study, says that recognizing sex-specific and nontraditional risks can change how we screen and educate patients. She notes that younger women may have a higher stroke risk than men of the same age and that risk levels flip as people get older.
The study does have some limitations. It was observational, meaning it reviewed past health records and cannot prove cause and effect. It also relied on participants reporting their own medical histories, which may not always be accurate. Most of the participants were white Europeans, so the findings might not apply to all populations.
This study was part of a larger project called SECRETO, which collected data from over 1,000 adults across 13 European countries between 2013 and 2022. The goal was to uncover what triggers cryptogenic strokes in young people and how to prevent them.
If you care about stroke, please read studies that diets high in flavonoids could help reduce stroke risk, and MIND diet could slow down cognitive decline after stroke.
For more health information, please see recent studies about antioxidants that could help reduce the risk of dementia, and tea and coffee may help lower your risk of stroke, dementia.
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