Prevalence of Stroke Rising Among Younger, Middle-Aged Adults in the US

The prevalence of stroke has increased by 14.6% from 2011 to 2022 among individuals aged 18 to 44 and 15.7% among those aged 65 and younger in the United States, according to a report published in Morbidity and Mortality Weekly Report.

Researchers assessed trends in stroke prevalence between 2011 and 2022, using data from the Behavioral Risk Factor Surveillance System (BRFSS), a state-based surveillance system administered to noninstitutionalized civilian adults in the US in collaboration with the Centers for Disease Control and Prevention (CDC).

Based on self-reported information in the BRFSS, participants who responded “yes” to questions regarding providers telling them they had a stroke were categorized as having stroke history. Sociodemographic data included age group, sex, race and ethnicity, educational level, and place of residence.

A total of 5,225,987 individuals from 50 states in the US and Washington District of Columbia (DC) were included in the analysis.

Age-standardized prevalence of stroke increased from 2.7% in 2011 to 2013 to 2.9% in 2020 to 2022, marking a 7.8% (95% CI, 4.9%-10.8%) increase in overall stroke prevalence. The researchers noted the highest stroke prevalence (7.7%; 95% CI, 7.5%-7.9%) among individuals aged 65 and older and the lowest prevalence (0.9%; 95% CI, 0.8%-1.0%) among individuals aged between 18 and 44 years.

Stroke was observed to be highest (5.3%; 95% CI, 4.7%-5.9%) among the American Indian or Alaska Native group and lowest among the Asian group (1.6%; 95% CI, 1.2%-2.0%).

With regard to educational level, individuals with a high-school diploma had the highest stroke prevalence (5.2%; 95% CI, 4.8%-5.4%) and those with a college degree or higher had the lowest stroke prevalence (1.7; 95% CI, 1.6%-1.8%).

During the period from 2011 to 2013 to the period from 2020 to 2022, increases in stroke prevalence was highest among adults aged between 18 and 44 years (14.6%), those who were Hispanic (16.1%), and adults with less than a high-school diploma (18.2%).

Significant increases in stroke prevalence were seen in 10 US states, with the highest increases in Ohio and Tennessee (20.9% and 20.7%, respectively). Of note, southern states had the highest stroke prevalence during 2020 to 2022.

Limitations of the analysis were BRFSS data were self-reported; bias due to BRFSS response rates being less than 50%; and potential full recovery of patients with acute stroke receiving timely treatment.

To highlight the clinical implications of the report, the researchers said, “Initiatives to promote knowledge of the signs and symptoms of stroke, and identification of disparities in stroke prevalence, might help effectively focus interventions to improve stroke prevention and treatment.”