No, Your 30s Aren’t Too Young to Think About Stroke Prevention—Especially as a Woman
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Erin Adelekun was 38 when she had a stroke, just nine days after giving birth to her daughter in 2020. It all started with a headache, which had been about a 2 on a scale of 1 to 10 when she was discharged from the hospital two days postpartum, and climbed to a 6 or 7 by the following week. She thought she was just exhausted from having a newborn and reassured herself she'd call her doctor the next day if it persisted. The next morning, she woke up with the worst throbbing head pain she’d ever felt. While she waited for her doctor's office to open, her husband offered to make breakfast. She tried to say she’d be down to the kitchen from their bedroom in a minute—but could only make indecipherable sounds.
“I tried to talk, but it was not coming out. I headed immediately down the stairs and my right arm became limp,” Adelekun tells SELF. “I knew I was having a stroke because I was familiar with the warning signs,” she says. But she couldn’t communicate that. Luckily, her husband recognized something was very wrong and rushed her to the hospital; upon arriving, she was whisked away for tests and treatment. The next thing she remembers is waking up three weeks later. She found out that in that time, she’d had a stroke, a seizure, a tracheotomy, and was airlifted to a different hospital.
While strokes most commonly occur in people aged 65 and older, about 10% to 14% of all strokes happen in people younger than 50. What's more: They are becoming increasingly common in younger adults, and the average age of someone who has a stroke is getting lower. In fact, strokes increased by about 15% in young adults from 2011 to 2022, according to data from the Centers for Disease Control and Prevention (CDC), with a higher increase among women than men.
Now for the good news: The 2024 national stroke prevention guidelines from the American Heart Association and American Stroke Association (which guide screening recommendations) recognize, for the first time, some of the unique risk factors young women face. For example, pregnancy and pregnancy complications, endometriosis, and hormonal birth control use are all associated with a higher chance of stroke. Doctors have known about these associations for years, Natalia S. Rost, MD, MPH, chief of the stroke division at Massachusetts General Hospital and a professor at Harvard Medical School, tells SELF. But there's now enough robust data supporting these links to call them out prominently and give recommendations around them, she says.
The guidelines are meant to inform primary care clinicians—including ob-gyns, since many women rely on them for routine care, says Eliza C. Miller, MD, an American Stroke Association national volunteer expert, associate professor of neurology at the Columbia University Irving Medical Center, and a co-author of the guidelines. But they can also give you more information about how your own health factors may contribute to your risk, so that you can advocate for yourself if need be. Here's everything you need to know about your stroke risk—including what you can do to reduce it and the signs to look out for.
What’s causing the increase in stroke in young women?
First, a quick refresh: A stroke is a medical emergency involving a disruption in blood flow in the brain that damages cells there. It’s caused by either sudden bleeding in the brain or a blockage of blood flow, which starves brain cells of oxygen. This happens as a result of an underlying condition, typically an issue with your blood vessels or a disease that affects them, Dr. Rost says.
While experts can't pinpoint one specific reason for why strokes are increasing in younger adults, high blood pressure is one of the biggest risk factors for intracerebral hemorrhage or ICH strokes, which occur when a blood vessel bleeds in the brain. And ICH strokes are increasing in young people. “People are starting to have higher blood pressure at younger ages, and it’s more poorly controlled, so they're experiencing the consequences of those cardiovascular risk factors,” Carolyn Cronin, MD, PhD, a neurologist and the medical director of the University of Maryland Young Stroke Center, tells SELF.
Having one risk factor isn't necessarily going to cause you to have a stroke. But multiple risk factors—including those related to cardiovascular health and the ones that were newly outlined in the 2024 guidelines—can “stack” on top of each other and make one more likely.
Jessica Diaz, a Boston-based barre instructor and certified personal trainer, was shocked when she had a stroke in her 30s. “I had no idea that people at 36 could even have strokes,” Diaz tells SELF. She experienced pain and numbness on one side of her body and the worst headache of her life, but was skeptical when her primary care physician told her to go to the emergency room (though she obliged). While undergoing testing at the hospital, she thought she might be having a migraine or maybe was about to be diagnosed with a brain tumor.
After her stroke, doctors discovered Diaz has a genetic disorder that increases her risk of blood clots and strokes. Being on hormonal birth control on top of that (which she had been taking since she was 16) made her chances of having a stroke even higher. Both of these things were news to her.
Stroke prevention steps to take in your 30s
Some risk factors, like your genetics and age, can’t be changed, Dr. Cronin says, so it’s all about managing the risk factors you can control. And even if you don’t have any additional known risk factors, everyone’s risk increases with age, so “the time for prevention is now,” Dr. Miller adds.
1. Prioritize yourself.
Your 30s are often a busy decade: You might be advancing in your career, buying a home, caring for young children, or assisting aging parents. Which often means you’re putting others first.
During the time she now knows she was having a stroke, Adelekun remembers thinking about what her daughter was going to eat. “I ignored my early symptoms because I had so many other things to do,” she says. “I’m a wife, daughter, and new mom, and I wasn’t thinking of my health because I was juggling all that. But it’s essential to put yourself first. Because if I hadn’t survived, I wouldn’t be here to celebrate any of my daughter’s milestones.”
Dr. Rost sees this often: “[Some] women don't like to ‘bother’ people, so they don't seek help,” she says. “[As doctors,] we are never bothered when people show up to the emergency room. We would rather have you come in and get checked out."
2. Focus on these health-promoting habits.
You’ve probably heard it a thousand times: Eat a Mediterranean-style diet, get enough sleep, exercise regularly, quit smoking if you haven’t yet. These essential habits protect you from all sorts of health problems, including stroke, Dr. Miller says, but that doesn’t mean it's always easy to implement or stick with them.
Need help figuring out where to start? Focus on one healthy habit where you can make some changes. For example, maybe you're not getting enough sleep—like if you have young kids or a late-night Netflix habit. “Sleep is so important for your brain health,” Dr. Miller says. “I tell my patients there's a reason we spend a third of our lives asleep.”
Or maybe you smoke cigarettes or vape: Many people fear lung cancer as a reason to quit smoking (or never start), but smoking is “very irritating to the blood vessels,” leading to blockages that can in turn lead to stroke, Dr. Cronin says. “Not smoking is a key preventive step to decrease your risk of stroke.”
Think about ways to make physical activity a part of your daily routine too. Remember you can start small, and try not to be too hard on yourself. If you find it’s difficult to actually get to the gym or your local Pilates studio, “park farther away from your office or get off the subway two stops earlier and walk,” Dr. Miller says. “Even those little interventions are super important…. You don’t need to feel bad about yourself if you didn’t, say, become a triathlete. Just make little changes.”
3. Get your numbers checked.
When’s the last time you went to the doctor? Hey, no shame—but it might be time to make an appointment. You have a lower risk of stroke if you have healthy blood pressure, blood sugar, and cholesterol levels. But you won’t know your numbers unless you get them checked. Some young people don’t even have a primary care doctor, Dr. Cronin says. If that’s you, a good stroke prevention step to take is to schedule your first visit.
Experts emphasize the importance of blood pressure screening in particular, as hypertension is a leading cause of stroke. Some young women may experience what’s come to be called white-coat hypertension, or elevated blood pressure at the doctor’s office due to nerves or anxiety (which is typically fleeting and NBD). But Dr. Miller doesn’t let anyone off the hook for that. “Maybe that's true, but let's make sure by sending you home with a blood pressure monitor and having you check your blood pressure at home every morning and give me a report,” she says. This way, they can be sure you’re not walking around with untreated high blood pressure.
4. Act quickly if you recognize any stroke symptoms.
Even if you do everything in your power to lower your risk of stroke, one can still happen. And if it does, you want to be able to recognize the signs so that you can get treatment quickly, Dr. Rost says.
Health organizations recommend memorizing the acronym B.E. F.A.S.T., which outlines the major signs of a stroke and reminds that quick treatment is of the essence:
Balance: sudden balance issues or changes
Eyes: double vision, loss of vision in one eye, or any other sudden vision changes
Face: drooping, numbness, or one side of the face looking “crooked”
Arm: weakness and numbness in one arm
Speech: difficulty talking or slurred speech
Terrible headache: especially with a sudden onset
Some organizations also use T to remind people of the importance of Time: The faster you get treated for a stroke, the better the outcome. Which is why it’s critical to call 911 and get checked out as soon as you notice symptoms, Dr. Rost says. Let the operator know you may be having a stroke, so that they can alert the paramedics. Once on site, the first responders can then give the hospital a heads up—and even bring you to a specialized stroke center if there's one nearby—so that they're prepared to administer appropriate treatment as soon as you arrive.
As a healthy young adult, how worried should you be about all of this?
“Even though the rate of stroke has been increasing among younger [adults], the vast majority of strokes are still in older [adults],” Dr. Cronin notes. And even if you do have an additional risk factor, like endometriosis or high blood pressure in pregnancy, “you're not doomed,” Dr. Miller reassures. But knowing you have an elevated risk is important—you can use that knowledge as power and the motivation you need to make small changes that can help keep you healthy.
To help other women take charge of their health, Adelekun shares her experience on Instagram at @stroke.mama. Thinking back to that fateful morning, she says she had been tempted to go back to sleep and see if her symptoms would just go away. “I thought a stroke could not happen to someone so young," she says. If she had, “I would not be here today.” She hopes her posts will also inspire other survivors: “I couldn't walk, talk, or move my right arm. But I moved out of the wheelchair and just walked a 5K.”
Diaz, too, is passionate about sharing her story in hopes it will help someone else. In fact, it already has: A mother of a girl in Diaz’s son’s kindergarten class came up to her years later while out to dinner in their neighborhood. “She said, ‘I want to thank you. I had a stroke, and I never would have called 911, but I had just read about your story and I recognized how you described your symptoms, so I got treatment right away.’ Just that one story is enough. She was just like me; she had no idea you could have a stroke this young.”
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Originally Appeared on Self
