Risk of Stroke Growing Among Women Under 50 and Women of Color

Risk of Stroke Is Growing Among Women Under 50 and Women of Color

Stroke patients are getting younger, and the risk also varies depending on race and ethnicity.
Risk of Stroke Is Growing Among Women Under 50 and Women of Color
Courtesy of American Heart Association; Canva

A FaceTime call with her family may have saved Dawn Turnage’s life. After a long day at work back in 2015, while she was chatting with her then 2-year-old niece, the child told her to “stop making funny faces.” Bewildered, Turnage thought her niece was joking until her sister, who is a physician assistant, got on the call and recognized the signs of a stroke.

Turnage, 45 at the time, brushed it off and blamed it on stress and being tired.

“I thought I was way too young to be having a stroke,” she recalls. But she was wrong.

At her family’s urging, she went to a nearby urgent care center, where she was referred to a local emergency room. Doctors told Turnage that she had suffered a transient ischemic attack (TIA), or a mini-stroke. Similar to an ischemic stroke, the most common type of stroke, a TIA occurs when a blockage cuts off blood flow to the brain. But unlike an ischemic stroke, a TIA blockage is brief and does not cause lasting damage.

A TIA can be a precursor to an ischemic stroke; one in three people with TIA will eventually experience a stroke, according to the Mayo Clinic. Half these strokes will occur during the year after the TIA.

More Young People Are Having Strokes

Each year, nearly 800,000 Americans have a stroke, according to the Centers for Disease Control and Prevention (CDC). This roughly translates to a stroke every 40 seconds. And every 3.5 minutes, someone in the United States dies of a stroke.

The risk of stroke increases with age, but it can occur at any time.

“It is a common misconception that strokes rarely occur in younger people, but this is not the case,” says Basit Rahim, MD, the director of stroke and neurocritical care at Providence Mission Hospital in Mission Viejo, California. “There is a growing rate of people under 50 who are having strokes.”

Research released in 2022 by the American Heart Association (AHA) found that while the rate of stroke in adults 75 and older has been declining, incidence of stroke in adults 49 and younger has increased in the past 30 years.

“Data has clearly illustrated that rates of obesity, inactivity, and metabolic syndrome have skyrocketed in the United States, in particular,” says Briana Costello, MD, a general and interventional cardiologist at the Texas Heart Institute. “These all increase risk for cardiovascular disease, and importantly, stroke.”

Type 2 diabetes and high blood pressure, a leading cause of stroke, are also becoming more common in younger adults, the AHA notes.

While some risk factors are modifiable, others, like genetics, are not. Certain underlying conditions may also increase the risk of stroke in young adults.

Moyamoya Disease and Stroke

Jia Wu was only 28 when she was deployed in Afghanistan and began experiencing symptoms of the first of several TIAs, though she didn’t know it at the time. She’d had a shoulder injury, so when she felt numbness and tingling down her arm on the same side, as well as a floppy wrist, she thought it was nerve damage from the injury.

“I was a relatively normal, healthy 28-year-old with no family history of neurological diseases,” Wu, now 30, says. She couldn’t have anticipated what would happen next.

When she returned home to the United States a couple of months later, she was still experiencing symptoms, but infrequently, and she didn’t put much thought into it. But one day when she was driving, her head involuntarily jerked backward. It lasted only a second, and she was able to right herself before anyone was harmed, but the incident frightened her.

“At that point, I realized that something was severely wrong,” Wu recalls.

She saw her doctor and underwent a series of tests. A brain MRI revealed that she had Moyamoya disease, a rare cerebrovascular disorder caused by blocked arteries at the base of the brain.

The disease was first discovered in Japan and is more common in East Asian countries and people of Asian descent who live in Western countries, per the Mayo Clinic.

In children, the first sign of Moyamoya disease is often a TIA. This may also occur in adults, as in Wu’s case, but it often presents as a hemorrhagic stroke caused by bleeding in the brain, according to the National Institute of Neurological Disorders and Stroke.

Wu underwent multiple surgeries, including procedures in which doctors removed a piece of her skull and grafted a superficial artery into her brain to redirect blood flow. After an arduous two years of surgeries and recoveries, she was able to return to the field as an Army intelligence captain.

Know the Signs of Stroke

To remember the warning signs of a stroke, the AHA recommends using the acronym FAST:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911

If you’re experiencing signs of a stroke, seek medical treatment right away.

“Early detection and treatment can make a world of difference for recovery,” Dr. Rahim says. “It’s important that you take your symptoms seriously and do not brush them off.”

TIAs and stroke have the same symptoms, and there is no way to tell whether someone is having a TIA or stroke once symptoms begin.

Racial Disparities in Stroke

Stroke is a major cause of death in the United States, but risk varies depending on race and ethnicity.

According to the CDC, Black Americans have nearly twice the risk of stroke compared with white Americans and have the highest death rate from stroke among all racial groups.

Hispanic people in the United States also face a higher rate of death from stroke than non-Hispanic whites, according to the AHA. And a study published in 2019 in JAMA Neurology found that Asian Americans experienced more severe strokes and had worse functional outcomes, such as longer length of stay in the hospital and greater disability than white patients.

The reasons for these racial disparities are varied and complex. Black and Hispanic Americans are more likely to have several risk factors for stroke, including obesity, high blood pressure, high cholesterol, and diabetes. Racial minorities are also more likely to be uninsured or underinsured and less likely to regularly see a doctor.

Turnage says she is blessed and lucky that she answered her niece’s phone call and is still here today. Since her TIA, she has not had any further incidents with her heart and continues to incorporate a healthy diet and exercise into her daily routine.

As a Black woman, Turnage works to raise awareness in her community about stroke and why it’s critical to form healthy lifestyle habits, especially if you’re at high risk. She and Wu are sharing their stories as volunteers for the American Heart Association's Go Red for Women "Real Women" initiative.

“I’ll continue to use my voice to create awareness, particularly for women who look like me,” Turnage says. “I encourage all women to make themselves a priority, go to your doctor appointments, be your own health advocate, and do your best to live a healthy lifestyle as much as possible.”

Wu advises women to pay attention to their bodies and have open communication with their doctors when they feel something isn’t right.

“If you have medical symptoms that are outside of your daily norm, start to log it in a journal,” she says. “That’s what I did, and it’s what assisted my providers in discovering that I had been experiencing mini-strokes for a longer period of time than they initially thought. It’s all about working with your provider and providing them the information that they need.”

anurag-sahu-bio

Anurag Sahu, MD

Medical Reviewer

Anurag Sahu, MD, is the director of the adult congenital heart program at Inova Health System in Fairfax, Virginia. Previously, he was an associate professor of medicine as well as an associate professor of radiology at Emory University in Atlanta, where he also served as director of cardiac intensive care.

He attended medical school at the University of Missouri in Kansas City in its combined six-year BA/MD program. He then completed his internal medicine residency at Washington Hospital Center in Washington, DC; fellowship training at Rush University in Chicago; and advanced training in cardiac imaging and adult congenital heart disease at The Ohio State University in Columbus.

Dr. Sahu has published book chapters on cardiovascular imaging as well as a variety of journal articles in publications including The Journal of Heart and Lung TransplantJACC: Cardiovascular Interventions, and the Journal of Thoracic Imaging.

Among the places that his career has taken him, his favorite was Kauai, Hawaii, where he was the only cardiologist on the island.

Ashley Welch

Author

Ashley Welch has more than a decade of experience in both breaking news and long-form storytelling. She is passionate about getting to the crux of the latest scientific studies and sharing important information in an easy-to-digest way to better inform decision-making. She has written about health, science, and wellness for a variety of outlets, including Scientific American Mind, Healthline, New York Family, Oprah.com, and WebMD.

She served as the health editor for CBSNews.com for several years as a reporter, writer, and editor of daily health news articles and features. As a former staff member at Everyday Health, she covered a wide range of chronic conditions and diseases.

Welch holds a bachelor's degree from Fordham University and a master's degree from the Craig Newmark Graduate School of Journalism at the City University of New York, where she studied health and science reporting. She enjoys yoga and is an aspiring runner.