Middle-aged people in the United States are more likely to die from a stroke than they have been in about two decades, according to a new report from the U.S. Centers for Disease Control and Prevention.
After at least a decade of decline, stroke deaths among people aged 45 to 64 began to rise in 2012. By 2019, stroke deaths in this age group had risen 7% from seven years earlier, and rose another 12% during the early years of the Covid-19 pandemic.
Stroke deaths in this age group fell slightly in 2022, but were still significantly higher than before the pandemic. More than 19,700 people aged 45 to 64 died from a stroke in 2022, the new report said — about 24 deaths per 100,000 people in this age group.
Stroke is the fifth leading cause of death in the US, with most strokes occurring in people aged 65 and older. Previous research has shown that Covid-19 infection increases the risk of stroke for people of all ages.
But the long-term increase in stroke deaths among middle-aged people contrasts with the downward trend seen among seniors and older adults over the past decade, says Sally Curtain, a statistician at the CDC’s National Center for Health Statistics and an author of the new report.
Racial and ethnic disparities in stroke death rates are also much higher among middle-aged adults than among older adults, she said. Among those 65 and older, the stroke death rate was 24% higher for black people than for white seniors; among those 45 to 64, it was 133% higher for black people than for white people.
According to the new report, middle-aged men are more likely to die from stroke than middle-aged women, and stroke death rates are higher in the South than in any other region.
In 2022, there were about 66 stroke deaths per 100,000 middle-aged black men living in the South — nearly three times the total rate for this age group.
Experts warn that middle age is an important time to monitor your health and manage risk factors such as high blood pressure, diabetes and obesity.
“A lot of people think of stroke as a disease for older people, and it is. The longer you live, the longer the risk factors can cause plaque to build up in your arteries,” says Dr. Elisabeth Breese Marsh, a vascular neurologist and director of the Comprehensive Stroke Center at Johns Hopkins Bayview. But arteries begin to harden in middle age, which can worsen the buildup and lead to complications.
“All of these risk factors are so prevalent in society, and we’re seeing them at younger and younger ages. It’s not uncommon for younger people to have strokes now because of these comorbidities,” said Marsh, who was not involved in the new report. “Nobody wants to feel old, but it’s by taking care of yourself earlier that you can really thrive in middle age and later in life.”
Stroke diagnosis and treatment options have evolved dramatically over the past decade, experts say. And new ways to address comorbidities, such as blockbuster GLP-1 drugs used to treat type 2 diabetes and obesity, hold promise in managing risk factors.
But it is crucial that people who have had a stroke act quickly and have equal access to health care and treatment, experts say.
According to the Mayo Clinic, strokes are often characterized by sudden, severe headaches, vision problems in one or both eyes, difficulty walking, paralysis or numbness in the face or limbs, and difficulty speaking or understanding others.
According to Marsh, the younger brains of middle-aged adults have great potential for recovery if treated quickly and aggressively. However, people in this age group may wait longer before seeking help because they are less likely to admit they need help.
“It’s really important, whether it’s the patient or their family, that they recognize the symptoms and get to the hospital as quickly as possible,” she said. “Those first few hours are critical.”
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