Strokes are no longer just a disease of old age. “From 1990 to 2021, the incidence of stroke in people under 55 increased,” according to The Lancet Neurology. The CDC also reports a 14.6% rise in stroke cases among adults aged 18–44 between 2011 and 2022.

Main Drivers: Hypertension, Obesity, and Substance Use

High blood pressure is the leading factor. “Half of patients under 44 with hypertension are unaware of their diagnosis,” says Richardson et al. (2024). This allows vascular damage to build up early in life. Obesity, which has doubled in 18–39-year-olds since 1999, leads to inflammation and artery damage. Meanwhile, vaping, cocaine, and synthetic cannabis increase stroke risk through clotting and blood vessel inflammation.

Specific Medical Triggers

Migraines with aura double the stroke risk, especially when combined with smoking or birth control. “Pregnancy triples the likelihood of stroke,” and oral contraceptives further raise the risk. Heart defects like a patent foramen ovale cause up to one-third of strokes in young adults.