Young people don't typically have strokes, so when they do, it can be frightening. We understand that older people have strokes more often than young people because the stroke risk factors, such as narrowing of the arteries, increase with age. But researchers are still trying to find out how to decrease the risk of stroke in people under 45 i.e. a group that doesn't typically have the risk factors of older people.
In a recent study, doctors found that stroke patients and healthy patients had similar levels of total cholesterol, but pinpointed low levels of the 'good' cholesterol, HDL, in stroke patients. HDL is believed to lower stroke risk. The results suggest that having your HDL cholesterol measured may be a good indicator of whether you're at risk for a stroke prematurely.
Every year, about 800,000 men have a stroke. A stroke is an attack caused by a clot or a ruptured vessel that has cut off blood flow to the brain. As many as 130,000 people will die each year from stroke-related complications, such as pneumonia or blood clots.
The Centers for Disease Control and Prevention ranks stroke as the fifth leading cause of death in men. Research shows that men are more likely to have a stroke, particularly men who are African American, Native Alaskan, or Native American. But that’s only the short-term risk. The lifetime risk is much lower for men than it is for women. Men are also less likely to die from a stroke. The ability to recognize stroke symptoms can help save lives. If you think someone is having a stroke, call your local emergency services immediately. Every second counts, don’t forget.
In fact, between years 2011 to 2012, hospitalizations for ischemic stroke, the most common type, caused by a clot that blocks blood flow to the brain, rose by 42 percent in men ages 35 to 44. That was the biggest spike seen in any age group during that time. And even younger guys aren’t immune, either. During that time, the hospitalizations rates for stroke in men ages 18 to 34 rose by 15 percent.
Risk Factors involved with strokes in young healthy men
Until recently, stroke in young adults had been thought to be associated with rare risk factors, including arterial dissection, reversible cerebral vasoconstriction syndrome, inflammatory arteritis, cardiomyopathy, and several hypercoagulable factors. But the evidence actually undermines the role of hypercoagulable conditions in the vast majority of early onset strokes, as is the case for prothrombin mutation and Factor V Leiden. The one exception is for those with a cerebral venous thrombosis.
Researchers noted that primary risk factors associated with the highest risk of recurrent stroke included the traditional vascular risk factors, including being older than 40, having a history of transient ischemic attack or type 1 diabetes, and taking anti-hypertensive medication. In addition, the studies reviewed showed that mortality risk also increased with the number of traditional cardiovascular risk factors.
The problem is, 20-, 30- and 40-year men think they are young and that these risk factors don’t affect them, that they are unlikely to have high blood pressure and that they are unlikely to have high cholesterol, but this is not the case. As already mentioned, stroke is the fifth leading cause of death and a major cause of disability in the country. A stroke occurs when the blood supply to part of the brain is obstructed, depriving brain cells of oxygen needed to survive. As a result, brain cells begin to die within a matter of minutes, causing irreversible brain damage, long-term disability or death. Approximately 795,000 Americans suffer a stroke each year.
Experts said that the increase is largely due to the rise in obesity-related lifestyle risk factors among younger people, including hypertension, diabetes and high cholesterol.
Approximately 28 percent of younger adults aged 20 to 39 were obese in 2005–2006, based on data from the CDC. A decade later, that rate jumped to 35.7 percent of younger adults in the same age range. Smoking, drinking and physical inactivity are also risk factors for a stroke.
How stroke in younger men is different
Treating and managing stroke in men, younger than 45 requires a different approach because you need to look for different causes. Compared with stroke in older people, stroke in the young is a different beast.
There are several types of stroke, but all of them are caused by decreased blood supply to the brain. The most common type is an ischemic stroke, and they're either caused by a blood clot in the brain's blood vessels, or a blood clot that develops outside the brain and travels to those vessels.
Cardiogenic causes account for more stroke in men. Another cause to watch out for in young people is drug use, especially intravenous drugs. Cardiogenic causes may include rheumatic heart disease, heart valve abnormalities, and being born with a hole between the right and left side of the heart, called a patent foramen ovale.
Up to 25 percent of stroke under age 45 is caused by a dissecting blood vessel in the neck. This is a small tear in a big blood vessel that causes a clot to form and travel to the brain. Other stroke causes that have been linked to younger stroke age include migraine, pregnancy, birth control pills, and smoking.
Common symptoms of strokes in younger men
For men and women, stroke is marked by an inability to speak or understand speech, a strained expression, inability to move or feel a part of the body, and confusion. Someone who is having a stroke may also have trouble talking or understanding conversation. There are no stroke symptoms unique to men.
The six most common symptoms of a stroke affect several parts of the body.
- Eyes - sudden trouble seeing in one or both eyes
- Face, arms, or legs - sudden paralysis, weakness, or numbness, most likely on one side of the body
- Stomach - throwing up or feeling the urge to be sick
- Body - overall fatigue or trouble breathing
- Head - sudden and severe headache with no known cause
- Legs - sudden dizziness, trouble walking, or loss of balance or coordination
The exact symptoms vary depending on which area of the brain is affected. Strokes often affect only the left or only the right side of the brain. In a survey performed with several men and women, found that women did better than men in correctly identifying the signs of a stroke, but only by a few percentage points.
Treatment for strokes in younger men
Ischemic stroke - About 85 percent of strokes are ischemic. This means that a blood clot cut off blood flow to the brain. The doctor will administer a drug called tissue plasminogen activator (tPA) to dissolve or break up the clot. To be effective, this medication must be administered within four and half hours of the first symptom’s appearance.
If tPA isn’t an option for some reason, your doctor will give you a blood thinner or other drug to stop platelets from clumping and forming clots. Surgery and other invasive procedures are also options. A doctor may perform an intra-arterial thrombolysis. During this procedure, medicine is delivered through a catheter inserted in your upper thigh.
Another option involves removing the clot through a catheter that reaches the affected artery in the brain. The catheter is coiled around the tiny arteries in your brain to help remove the blood clot. If you have plaque buildup in the arteries in your neck, your doctor may also suggest a procedure to unblock these arteries.
Hemorrhagic stroke - This type of stroke happens when an artery in the brain ruptures or leaks blood. Doctors treat a hemorrhagic stroke differently than they do an ischemic stroke. They also treat the stroke differently depending on the cause.
Preventive measures for strokes in younger men
Obesity in men is up in America, and that increases the lifetime risk for stroke. Obesity increases the risk for high blood pressure, high cholesterol, and diabetes. These are all important stroke risk factors at any age. It's never a bad time to apply these stroke prevention strategies:
- Work with your doctor to identify underlying diseases.
- Exercise regularly and maintain a healthy weight.
- Eat a diet low in saturated fat and high in fruits, vegetables, and whole grains.
- Start controlling high blood pressure and high cholesterol at an early age.
- Recognize and control diabetes.
- Avoid alcohol, drugs, and smoking.
One of the big differences between stroke in older people and younger people is recovery. Stroke in young people can mean a lifetime of recovery and a loss of many productive years. About 15 to 30 percent of people who have a stroke have some long-term disability. The good news is that a 30-year-old has a better rate of recovery than an 80-year-old because of better brain plasticity.
The key to managing stroke in young people is to identify and treat the underlying causes. Reducing risk factors, just as in older stroke, is the key to preventing a first stroke or a recurrent stroke.